Abstract
BackgroundContinuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief. A common problem encountered with CPNCs is pericatheter leakage, which can lead to dressing adhesive failure. Frequent dressing changes increase the risk of catheter dislodgement and infections. Adhesive glue is effective in securing the peripheral nerve catheter and decreasing leakage around the catheter insertion site. This study aimed to evaluate the incidence of pericatheter leakage with fixation using 2-octyl cyanoacrylate glue (Dermabond®) as compared to sterile strips.MethodsThirty patients undergoing unilateral total knee arthroplasty (TKA) with continuous femoral nerve catheter for postoperative analgesia were randomized into the catheter fixation with 2-octyl cyanoacrylate glue (Dermabond®) group or the sterile strip group. The primary outcome was the incidence of pericatheter leakage. Secondary outcomes included the frequent of catheter displacement, the difficulty of catheter removal, pain score and patient satisfaction.ResultsThe incidence of pericatheter leakage at 24 and 48 h was 0% versus 93 and 0% versus 100% in the Dermabond® and sterile strip groups, respectively (P < 0.001). The incidence of displacement at 24 and 48 h was 6.7% versus 93.3 and 6.7% versus 100% in the Dermabond® and sterile strip, respectively (P < 0.001). There was no difference in numeric rating scale, difficulty of catheter removal, or satisfaction scores between groups.ConclusionsCatheter fixation with 2-octyl cyanoacrylate glue (Dermabond®) decreased the incidence of pericatheter leakage, as well as catheter displacement, over 48 h as compared to sterile strip fixation.Trial registrationThis trial was registered on Thai clinical trial registry: TCTR20200228002, registered 24 February 2020- Retrospectively registered.
Highlights
Continuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief
The primary aim of this study is to evaluate the incidence of pericatheter leakage by using sterile stripe or 2ocylcyanoacrylate (Dermabond®) in continuous femoral catheter
There was no significant difference in the sex, age, body mass index (BMI), and ASA physical status of the subjects (Table 1)
Summary
Continuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief. Adhesive glue is effective in securing the peripheral nerve catheter and decreasing leakage around the catheter insertion site. Continuous peripheral nerve catheters (CPNCs) provide sustained postoperative pain relief with an opioidsparing effect, improved rehabilitation, and patient satisfaction [1,2,3]. Previous studies [7,8,9,10] have shown that adhesive glue was an effective method of peripheral nerve catheter fixation; leakage around the pericatheter was only the secondary outcome of these studies. The fixation of the peripheral catheter with 2ocylcyanoacrylate (Dermabond®) may improve leakage by sealing effect at the puncture site, and securing the continuous femoral nerve catheter with 2ocylcyanoacrylate (Dermabond®) would reduce the incidence of pericatheter leakage within the first 48 h. The secondary outcomes were catheter displacement, numeric rating scale score (NRS), difficulty of catheter removal, and patient satisfaction with analgesia
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