Epidural catheter migration: a comparison of tunnelling against a new technique of catheter fixation.

Anaesth Intensive Care

Wellington Hospital, Capital Coast Health Limited, Wellington South, New Zealand.

Published: October 2003

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).

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http://dx.doi.org/10.1177/0310057X0303100505DOI Listing

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