Basic/Core Supplies and Equipment for Pain Interventional Specialists

Most pain management interventional procedures rely on a common set of basic supplies, which we’ll consider “core” disposables and equipment.

Sterile Disposables

For disposables, there are two ways to go about this:

  1. Open up the specific supplies needed for each procedure each time:
    1. While this does minimize waste, it can get tedious and with the short procedure time and potentially high volume/fast turnaround, this can make procedure workflow difficult.
  2. Alternatively you can use a common procedure tray that has a set of items that are common to most procedures (even if not all procedures):
    1. This is the inverse of above: might cause some waste, but is much faster and often times isn’t a significant difference in cost.
    2. You can get custom trays or buy trays for this purpose.

The common items/needs that you’ll want to consider:

  1. A pointer that can be identified in “scout” fluoro images to identify entry points when starting procedures.
    1. Anything radiopaque works, but a large (ie 20-30cc syringe) with a large guage basic needle works well. It is easily identifiable and when the plunger extended it can keep you hands away from the radiation.
  2. A large needle (ie, 18g) to draw up meds from vials (such as drawing up steroid)
  3. Troughs: You’ll often want several meds (ie, lidocaine, bupivacaine, contrast, saline, etc) and if they are simply put into a trough in a tray they’re easy to draw up rather than having to draw them up each procedure from a vial
  4. A 25g x 3.5″ subcutaneous needle for subcutaneous local anesthetic (in some cases this can even act as your primary needle for the procedure)
  5. 2-3 small syringes.
    1. Choice varies but 5cc syringes tend to work well. They can hold meds for subcutaneous local or joint injectate.
  6. A 10cc syringe is also useful for procedures where you’re injecting larger amounts of meds.
  7. A single fenestrated drape to keep the work area sterile
  8. Prep solution to sterilize the operative area
  9. A primary needle
    1. Most techniques outlined on TheProcedureGuide call for a 22g x 3.5″ quincke needle, however this can vary a lot. Larger patients might need a 5″ needle. Some procedures require a 7″ needle or can get away with a subcutaneous needle.
    2. So this needle could be opened on a case by case basis

As you can see from the above list a common tray can be designed (see link above) that might work well in most cases.

Equipment

  1. C-arm
  2. OR table capable of allowing a C-arm underneath
  3. Step stool – some patients (especially those with chronic pain and limited mobility) might need step stools to get on the table
  4. Other general procedure room supplies like monitor for vitals, emergency supplies, etc.