Dislocation rates of perineural catheters: a volunteer study

Dislocation rates of continuous peripheral nerve block are poorly described even though this technique is frequently used in clinical practice. The present study was designed to evaluate dislocation rates over time of interscalene and femoral nerve catheters under defined experimental circumstances....

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 2013-11, Vol.111 (5), p.800-806
Main Authors: Marhofer, D., Marhofer, P., Triffterer, L., Leonhardt, M., Weber, M., Zeitlinger, M.
Format: Article
Language:English
Subjects:
anaesthetic techniques, regional, brachial plexus
anaesthetic techniques, regional, lumbar plexus
Anatomy, Cross-Sectional
Anesthetics, Local - administration & dosage
Anesthetics, Local - pharmacokinetics
Brachial Plexus
Catheterization, Peripheral - adverse effects
Catheters
Femoral Nerve
Humans
monitoring, ultrasound
Nerve Block - adverse effects
Peripheral Nerves
Point-of-Care Systems
Prospective Studies
Spinal Nerve Roots - anatomy & histology
Spinal Nerve Roots - diagnostic imaging
Ultrasonography, Interventional
Young Adult
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Summary:Dislocation rates of continuous peripheral nerve block are poorly described even though this technique is frequently used in clinical practice. The present study was designed to evaluate dislocation rates over time of interscalene and femoral nerve catheters under defined experimental circumstances. Ultrasound (US) monitoring was used to detect the position of the perineural catheters. Twenty volunteers received US-guided interscalene and femoral nerve catheters. The volunteers performed standardized physical exercises in regular intervals and the position of both catheters was examined by US confirmation of the spread of fluid. The maximal time of investigation in each volunteer was 6 h. The main outcome parameters were the overall dislocation rates and the cumulative dislocation rates at a given time point. We observed an overall dislocation rate of 15% (5% for interscalene catheters, 25% for femoral nerve catheters) and a significant correlation between time and rate of dislocations (r=0.99, P=0.001). US visualization of the spread of fluid was possible in all cases. This is the first dedicated evaluation of dislocation rates of peripheral nerve catheters (PNCs) via US investigation. Both movement and time are considerable factors for perineural catheter displacement. US is useful for the performance of PNCs and for the continuous detection of the spread of fluid relative to the nerve and adjacent anatomical structures. Translational research is required to confirm the study results in the clinical practice. DRKS00003494.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/aet198