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CONTINUOUS ADDUCTOR CANAL BLOCK WITH A SUTURE-METHOD CATHETER – PRIMARY PLACEMENT AND SECONDARY REPOSITIONING
ESRA Academy. Lyngeraa T. Sep 8, 2016; 138581
Topic: Peripheral Nerve Blocks
Disclosure(s): T. Lyngeraa has received funding from an unconditional grant from Ferrosan Medical Devices to the Department of Anesthesiology, Nordsjællands Hospital for performing research on the Certa Catheter™
Tobias Lyngeraa
Tobias Lyngeraa

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Abstract
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Background and Aims:

To investigate primary placement of a suture-method catheter for adductor canal block using a short-axis (SAX) and long-axis (LAX) approach.

Methods:

We conducted a single-centre, assessor-blinded, randomized trial with 16 volunteers following ethical approval (H-15016829).

According to randomization, one catheter was inserted in the short-axis plane of the adductor canal using an in-plane technique. The second catheter was inserted in the long-axis plane of the adductor canal in the opposite leg using combined in-plane and out-of-plane techniques.

Correct position was confirmed by loss of cold sensation in the saphenous area 30 minutes after injection of 15mL lidocaine 10mg/mL. Furthermore, distance from catheter orifice to femoral artery (SAX) or subsartorial aponeurosis (LAX) was assessed during injection.

Volunteers returned the following day (day 2) where injections and assessments of sensory function and distances were repeated. If displaced, repositioning of the catheter was attempted.

Results:

100% (95% CI [81-100%]) of primary placements were successful using the SAX approach and 94% (95% CI [72-99%]) with the LAX  approach.

On day 2, one LAX catheter and three SAX catheters were displaced. We successfully repositioned all catheters, except for one SAX catheter that was completely displaced below the skin making repositioning impossible.

LAX insertion took longer than SAX insertion and the catheter was more difficult to visualize on day 2.

Three volunteers reported transient neurological deficits in the SAX leg lasting approximately 6-8 weeks.


Conclusions:

The suture-method catheter can be inserted with a high success rate. Moreover, the catheter can be repositioned in case of displacement. 

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