Epidural catheter migration: a comparison of tunnelling against a new technique of catheter fixation.
We investigated the efficacy of a new technique of epidural catheter fixation that relies on a strip of adhesive foam transfixed by a securing suture. We compared this technique to a tunnelled technique in a prospective, randomized trial (n = 25 in each group). Epidural catheter depth was recorded at the time of insertion and at the time of removal. Clinically significant catheter movement was considered as > 2 cm outward movement or > 1 cm inward movement. The mean duration of epidural analgesia was five days for both groups. Clinically significant movement was noted in eight patients (32%) in the tunnelled group and seven patients (28%) in the sutured group (P = 0.75). Movement of the epidural catheter did not correlate with analgesic failure. The sutured technique provided similar protection against migration to tunnelling but any potential advantages were offset by concerns about a significantly higher incidence of erythema around the catheter exist site in the sutured group (1 vs 6 patients, P = 0.04).
Wellington Hospital, Capital Coast Health Limited, Wellington South, New Zealand.
V L
VL
Chadwick
M
M
Jones
B
B
Poulton
B G
BG
Fleming
D000269:Adhesives; D000328:Adult; D015360:Analgesia, Epidural / Q000295:instrumentation* / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D016009:Chi-Square Distribution; D005548:Foreign-Body Migration / Q000517:prevention & control*; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D013537:Sutures
D000269:Adhesives