Intracorporeal knotting of a femoral nerve catheter.
Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention.
Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.
Mohamed
M
Ghanem
Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany.
Jörg
J
Schnoor
ACQUA Clinic, Leipzig, Germany.
Martin
M
Wiegel
Department of Orthopedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.
Christoph
C
Josten
Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany.
Andreas W
AW
Reske
complications; femoral nerve catheter; peripheral nerve catheters; postoperative pain management; regional anesthesia