A comparison of strength for two continuous peripheral nerve block catheter dressings

Lindsay Borg, Steven K Howard, T Edward Kim, Lauren Steffel, Cynthia Shum, Edward R Mariano, Lindsay Borg, Steven K Howard, T Edward Kim, Lauren Steffel, Cynthia Shum, Edward R Mariano

Abstract

Background: Despite the benefits of continuous peripheral nerve blocks, catheter dislodgment remains a major problem, especially in the ambulatory setting. However, catheter dressing techniques to prevent such dislodgment have not been studied rigorously. We designed this simulation study to test the strength of two commercially available catheter dressings.

Methods: Using a cadaver model, we randomly assigned 20 trials to one of two dressing techniques applied to the lateral thigh: 1) clear adhesive dressing alone, or 2) clear adhesive dressing with an anchoring device. Using a digital luggage scale attached to a loop secured by the dressing, the same investigator applied steadily increasing force with a downward trajectory towards the floor until the dressing was removed or otherwise disrupted.

Results: The weight, measured (median [10th-90th percentile]) at the time of dressing disruption or removal, was 1.5 kg (1.3-1.8 kg) with no anchoring device versus 4.9 kg (3.7-6.5 kg) when the dressing included an anchoring device (P < 0.001).

Conclusions: Based on this simulation study, using an anchoring device may help prevent perineural catheter dislodgement and therefore premature disruption of continuous nerve block analgesia.

Keywords: Anchoring device; Continuous peripheral nerve block; Dislodgement; Dressing; Perineural catheter; Regional anesthesia.

Figures

Fig. 1. Image showing the experimental model…
Fig. 1. Image showing the experimental model used to test the clear adhesive dressing with an anchoring device. Inset box: image showing the simulated dressing after disruption caused by application of force.
Fig. 2. Weight measured (kg) at the…
Fig. 2. Weight measured (kg) at the time of dressing disruption or removal. Boxes indicate the 10th–90th percentiles; whiskers indicate the range.

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Source: PubMed

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