title: Dislocation rates of perineural catheters: a volunteer study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
authors.forename: D
authors.initials: D
authors.lastname: Marhofer
authors.forename: P
authors.initials: P
authors.lastname: Marhofer
authors.forename: L
authors.initials: L
authors.lastname: Triffterer
authors.forename: M
authors.initials: M
authors.lastname: Leonhardt
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.forename: M
authors.initials: M
authors.lastname: Zeitlinger
mesh_terms: D019412:Anatomy, Cross-Sectional; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000493:pharmacokinetics; D001917:Brachial Plexus; D002406:Catheterization, Peripheral / Q000009:adverse effects; D057785:Catheters; D005267:Femoral Nerve; D006801:Humans; D009407:Nerve Block / Q000009:adverse effects*; D010525:Peripheral Nerves; D019095:Point-of-Care Systems; D011446:Prospective Studies; D013126:Spinal Nerve Roots / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local
keywords: anaesthetic techniques, regional, brachial plexus; anaesthetic techniques, regional, lumbar plexus; monitoring, ultrasound