Save
DISLOCATION RATE OF INTERSCALENE PERINEURAL CATHETERS AFTER ULTRASOUND-GUIDED, IN-PLANE PLACEMENT USING A POSTEROLATERAL APPROACH
ESRA Academy. Van Loon P. Sep 8, 2016; 138523
Topic: REGIONAL ANAESTHESIA (RA) TECHNIQUES - CLINICAL IMPLICATIONS
Disclosure(s): none
Dr. Philippe Van Loon
Dr. Philippe Van Loon

Access to Premium content is currently a membership benefit.


Click here to join ESRA or renew your membership.

Abstract
Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

Shoulder surgery is associated with severe postoperative pain. Efficient analgesia can be achieved with  a brachial plexus block. While some have advocated the insertion of a catheter for continuous administration of local anesthetics, there is a paucity of data on the failure rate of continuous peripheral nerve block (CPNB) caused by catheter dislocation.

Methods:

In this prospective observational trial, we included 100 consecutive patients planned for elective shoulder surgery under general anaesthesia and continuous brachial plexus block. We used an in-plane, ultrasound guided technique for the insertion of the CPNB catheter.

Control of correct catheter placement was done immediately postoperatively (POD0) and on the first postoperative day (POD1). Ultrasound guided visualization of spread in the interscalene space upon injection of 5cc lidocaine 1% was used for confirmation.

Results:

Success rate of the initial single shot was 99%. Catheter dislocation was 39% immediately postoperatively and 48% on POD1. The exact mechanisms leading to catheter dislocation remain unclear.

In patients with a  confirmed correct position of the catheter tip on ultrasound, VAS scores for pain on D1 were lower compared to patients with a dislocated catheter (19±21 vs. 41±24)

Conclusions:

The incidence of catheter dislocation during CPNB of the brachial plexus is disturbingly high, quantified at 48%. Interestingly, the majority of dislocations seem to occur intra-operatively, with postoperative dislocation appearing to be rarer.

Postoperative verification of correct catheter placement is possible and can probably lead to an increase in patient comfort and a substantial cost reduction, by avoidance of starting pain pumps on a dysfunctional catheter.
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings