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SUCCESSFUL REPOSITIONING OF THE SUTURE-METHOD CATHETER FOR CONTINUOUS BRACHIAL PLEXUS BLOCK: PRESENTATION OF THREE CASES
Author(s): ,
Lyngeraa, T.*
Affiliations:
Nordsjællands Hospital, Department of Anaesthesiology, Hillerød, Denmark
,
Christiansen, C.B.
Affiliations:
Nordsjællands Hospital, Department of Anaesthesiology, Hillerød, Denmark
Rothe, C.
Affiliations:
Nordsjællands Hospital, Department of Anaesthesiology, Hillerød, Denmark
ESRA Academy. Lyngeraa T. Sep 13, 2017; 190902
Topic: Upper Limb Blocks - Brachial Plexus Block
Tobias Lyngeraa
Tobias Lyngeraa

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Abstract
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Background and Aims:

Advancement and final positioning of perineural catheters may be difficult and possibilities for repositioning are limited. We describe the use of a novel suture-method catheter for brachial plexus block in three cases and successful repositioning after displacement of the catheter

Methods:

The suture-method catheters were placed at the superior trunk of the brachial plexus for postoperative pain control after major shoulder surgery. We inserted the catheters using an in-plane, short-axis technique. The curvature of the needle and expected trajectory both towards and away from the plexus was considered.

Two patients presented with moderate to severe pain in the evening on first postoperative day due to catheter displacement. A third patient was examined immediately after surgery and spread from injection through the catheter was assessed to be inadequate. In each case, the position of the catheter orifice was confirmed by ultrasound visualization and injection of local anaesthetic. This enabled repositioning by pulling either end of the catheter 

catheter placed at the superior trunkResults:

We successfully repositioned the catheters in all patients. Subsequent injection of local anaesthetic resulted in immediate pain relief for the two cases presenting with moderate to severe pain and ultimately sustained pain relief in all cases

Conclusions:

This case series demonstrates that a new suture-method catheter can be used for successful continuous block of the brachial plexus and that displacement can be corrected by use of ultrasound obviating the need for repeat needling

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