Ultrasound guided repositioning of a new suture-method catheter for adductor canal block - a randomized pilot study in healthy volunteers

Abstract

Background: We performed a randomized, blinded pilot study in 12 volunteers to assess the feasibility to reposition an intentionally displaced suture-method catheter for two different insertion techniques for adductor canal block.

Methods: Each volunteer had an ultrasound-guided suture-method catheter placed in the adductor canal (AC) in both legs. The catheters were placed using a perpendicular technique in one leg and a parallel technique in the other leg, according to randomization. 15 mL lidocaine 1% (LA) was injected in each catheter. Successful primary placement was defined as combined LA spread within the AC and loss of cold sensation 15 min after injection. All catheters were intentionally displaced, and subsequently repositioned using ultrasound. Another dose of lidocaine (15 mL 1%) was injected through the catheters and assessed for successful repositioning.

Results: Successful primary placement was achieved in 83% (95% CI 55-95%) of catheters placed perpendicular to the AC, and in 75% (95% CI 47-91%) of catheters placed parallel to the AC. Of those with successful primary placement, 100% (95% CI 72-100%) of catheters placed perpendicular to the AC, and 67% (95% CI 35-88%)) placed parallel to the AC could be repositioned.

Conclusions: Placement and secondary repositioning after displacement of a suture-method catheter within the adductor canal is achievable. A perpendicular technique seems more reliable.

Trial registration: NCT03315481 clinicaltrials.gov . The study was submitted on March 1, 2017. Due to clerical error, the study was posted on October 20, 2017.

Keywords: Adductor canal block; Catheter insertion technique; Continuous peripheral nerve block; Perineural catheter.

Conflict of interest statement

Ethics approval and consent to participate

All volunteers gave their written informed consent before participation. The study was approved by the Regional Ethics Committee (H-16029530) the Danish Data Protection Agency and registered at Consent for publication

Not applicable.

Competing interests

The Certa Catheter™ has been invented and developed by K. H. W. Lange and C. Rothe in collaboration with the manufacturer, Ferrosan Medical Devices (FeMD; patent no. WO2015081967).

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1

Illustration of the Suture-method catheter. The 19G nylon catheter is connected to the end of the needle. A detachable hub covers the connection. It has an injection port that allows injection through the needle. The proximal part of the catheter, closest to the hub, alternates in containing air and glue to increase echogenicity. The distal part of the catheter is patent with orifices at transition zone between proximal and distal part of the catheter. A Luer Lock injection port at the end of the catheter allows injection through the catheter

Fig. 2

Modified CONSORT flow chart

Fig. 3

Bland-Altman plots for estimation of displacement distance for perpendicular and parallel insertion techniques. a: Perpendicular approach. b: Parallel approach