DISLOCATION OF CATHETERS DURING CONTINUOUS PERIPHERAL NERVE BLOCKS. AN INVISIBLE PROBLEM
Keywords:
regional anaesthesia, post-operative pain management, certa catheter, dislocation of catheter, dislodgement of catheters, continuous peripheral nerve blocksAbstract
Relevance. The frequency of catheter dislocation remains unknown. Dislodgement can rise up to 30 % and might affect the quality of postoperative regional analgesia. The manufacturers introduce an increasing number of technical solutions, which improve the original placement and provide the potential possibility to correct the catheter location during a post-operative analgesia. Materials and methods. The catheter over needle are good option to reduce dislodgement of peripheral nerve catheters. New type of catheter — Certa Catheter has original design and might be an alternative during continuous peripheral nerve blocks. Further studies are guarranteed. Optimal care, adequate fixation, antiseptic technique stay main factors to diminish this problem. Results. Clinical data showed that the problem of catheter dislodgemnt by peripheral nerve blocks is underestimated. The frequency of displacement is very high and might affect the quality of postoperative regional analgesia. The reasons of dislocation has been not determined completely. Conclusions. The catheters over needle can diminish the leakage around the catheter and increase the resistance. The Certa Catheter is a new promissing method and further investigations are guarranteed. The proper care and attention stay main factors decreasing dislocation of the catheters.
References
Marhofer D. Dislocation rates of perineuralcatheters: a volunteer study. Br J Anaesth. 2013 Nov; 111(5): 800-6.
Tsui B.C.H. et al. Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block. Can J Anesth 2012; 59: 655-661.
Rothe C. et al. A novel suture method to place and adjust peripheral nerve catheters Anaesthesia 2015, July; 70 (7): 791-6.
Rothe C. et al. A Novel Concept and Catheter for Continous Peripheral Nerve Blocks — Ultrasound and Magnetic Resonance Imaging Evaluation of Initial Placement and Readjustment in Fresh Cadavers. Spring 2015 Abstract ASRA 40th Annual Regional Anesthesia and Acute Pain Medicine Meeting, May 14-16, 2015.
Rothe C. et al. A novel concept for continuous peripheral nerve blocks. Presentation of a new ultrasound-guided device. Acta Anaesthesiology Scandinavica 2015; Feb; 59 (2): 232-7.
Ben Tsui T. Catheter-over-needle method reduces risk of perineural catheter dislocation. BJA 2013: 759-760.
Tuyakov B. et al. Continuous peripheral nerve block (CPNB) with the use of Certa Catheter™. Case series, 35th Annual ESRA Congress 2016, Maastricht, The Netherlands.
Lyngeraa T.S. et al. Primary placement and secondary repositioning of a new suture-method catheter for continuous adductor canal block,35th Annual ESRA Congress 2016, Maastricht, The Netherlands.
Hauritz R.W. et al. Displacement of popliteal sciatic nerve catheters after major foot and ankle surgery. BJA 2016: 220-227.
Ilfeld B.M. Continuous Peripheral Nerve Blocks in the Hospital and at Home. Anesthesiology Clin 2011; 29: 193-211.
Machia A.T., Brian M. Ilfeld. Continuous peripheral nerve blocks in the ambulatory setting: an update of the published evidence. Curr Opin Anesthesiol. 2015; 28: 648-655.
Aguirre Jose, Alicia DelMoral, Irina Cobo, Alain Borgeat and Stephan Blumenthal. The Role of Continuous Peripheral Nerve Blocks. Review Article. Anesthesiology Research and Practice 2012: 1-20.
