title: Risk of catheter-associated infection in young hematology/oncology patients receiving long-term peripheral nerve blocks.
abstract: BACKGROUND
  Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheter-associated infection with prolonged CPNBs has not been previously investigated.
  
  
  OBJECTIVE
  We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage.
  
  
  METHODS
  All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records.
  
  
  RESULTS
  The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively.
  
  
  CONCLUSIONS
  Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥ 10 days) use.
authors.affiliation: Division of Anesthesia and Pain Management Service, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.  doralina.anghelescu@stjude.org
authors.forename: Doralina L
authors.initials: DL
authors.lastname: Anghelescu
authors.forename: Brittney L
authors.initials: BL
authors.lastname: Harris
authors.forename: Lane G
authors.initials: LG
authors.lastname: Faughnan
authors.forename: Linda L
authors.initials: LL
authors.lastname: Oakes
authors.forename: Kelley B
authors.initials: KB
authors.lastname: Windsor
authors.forename: Becky B
authors.initials: BB
authors.lastname: Wright
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: McCullers
mesh_terms: D000293:Adolescent; D000328:Adult; D000698:Analgesia / Q000295:instrumentation*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006405:Hematology; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008495:Medical Oncology; D009407:Nerve Block / Q000295:instrumentation*; D010525:Peripheral Nerves / Q000187:drug effects; D012189:Retrospective Studies; D018570:Risk Assessment; D013714:Tennessee / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents