Continuous Peripheral Nerve Blocks With Stimulating Catheters

Pham-Dang, Charles; Kick, O.; Collet, Thurial; Gouin, F.; Pinaud, M.

doi:10.1097/00115550-200303000-00002

Cited by 77 publications

(13 citation statements)

References 10 publications

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“…Les cathe´ters ont e´teṕ lace´s à des angles de 15°et 30°et a`des profondeurs de Continuous catheter regional anesthesia has been used successfully at a number of block sites 1 and provides effective pain relief with reduced incidence of side effects and an improved quality of life. 2,3 Accurate catheter placement is a major determinant of successful continuous peripheral nerve block (PNB), and incorrect positioning of catheters occurs in up to 40% of cases, 4,5 leading to an alarmingly high rate of secondary block failure. The recent introduction of stimulating catheters 6,7 and ultrasound 8,9 has improved the accuracy of catheter positioning; however, catheter dislodgement and leakage at the insertion site remain well-recognized but largely unresolved problems.…”

Section: Résumémentioning

confidence: 99%

Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block: an ex vivo study

Tsui

2012

Can J Anesth/J Can Anesth

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Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block: an ex vivo study Moins de fuites et de déplacements avec un cathéter par-dessus l'aiguille qu'avec un cathéter à travers l'aiguille pour un bloc nerveux périphérique: une étude ex vivo Abstract Purpose The objective of this study was to compare the catheter-through-needle (CTN) and catheter-over-needle (CON) catheterization techniques ex vivo by measuring leak pressure around the catheter and the catheter's resistance to pulling force. Methods Using an ex vivo porcine limb model, we compared the conventional CTN design with the CON design with respect to the ability to resist leakage at the catheter insertion site under high injection pressure and the force required to withdraw the catheter from tissue. One CON assembly (MultiSet, Pajunk) and three CTN assemblies (Contiplex, B.Braun; StimuCath, Arrow; Stimulong Sono, Pajunk) were studied. Ten porcine hind limbs were used to test leakage and another ten were used to measure withdrawal force. Catheters were placed at angles of 15°and 30°at depths of 3 cm and 5 cm. Leakage was assessed visually at the insertion site, and pressure was measured at the moment leakage occurred. Withdrawal force was measured by pulling the catheter from the tissue. Results No evidence of leakage was detected at the CON catheter insertion site at the highest pressure applied (1,000 mmHg) (n = 40). The CON assembly withstood significantly higher injection pressure than the CTN catheters without causing leaks at the catheter insertion site [CON, mean (standard deviation) [ 1,000 (0)

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Section: Résumémentioning

confidence: 99%

Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block: an ex vivo study

Tsui

2012

Can J Anesth/J Can Anesth

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“…A study performed by Pham Dang et al (Pham Dang et al, 2003) concluded that the ability to electrostimulate nerves using an in situ catheter increases success rate in catheter placement for continuous peripheral nerve blocks. However, they were surprised to find that the amperage required to elicit motor responses is higher with the stimulating catheter than with the introducer needle.…”

Section: Catheter Tipmentioning

confidence: 99%

Efficacy of Continuous Femoral Nerve Block with Stimulating Catheters Versus Nonstimulating Catheters - A Systematic-Narrative Review

Dauri¹,

Celidonio²,

Nahmias³

et al. 2012

Pain Management - Current Issues and Opinions

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IntroductionA femoral nerve block is simple to perform, has a high rate success, carries a low risk of complications, and it is widely used technique for surgical anesthesia and post-operative pain management of the lower extremity. It provides analgesia to the anterior thigh, including the flexor muscles of the hip and extensor muscles of the knee and therefore, it is well suited for surgeries that involve the hip, the knee or the anterior thigh zone. The femoral nerve block is often associated with sciatic nerve block in order to achieve a lower extremity analgesia. The anterior approach to the femoral nerve block initially described as a 3-in-1 block by Winnie et al (Winnie et al., 1973), suggested that the femoral, lateral femoral cutaneous, and obturator nerves could be blocked from a single paravascular injection at a point inferior to the inguinal crease. Studies have since showed that the femoral can be reliably blocked by a single injection, the lateral femoral cutaneous nerves is blocked in 95%, but the obturator nerve is almost always spared (Parkinson et al., 1989). Therefore, a 3-in-1 block with the paravascular approach seems difficult to obtain, and, as a consequence, when all three nerves need to be anesthetized a posterior lumbar plexus block or a multitruncular block should be performed. The anterior approach to the femoral nerve is similar for "single shot" or continuous nerve blocks. A femoral nerve block can be obtained with single shot of local anesthetic or by using a continuous catheter technique. The localization of the femoral nerve can be obtained by the use of nerve stimulator or with ultrasound guidance. When using single shot technique, the local anesthetic agent is injected through the needle after location of the nerve with the nerve stimulator. When using continuous catheter techniques, the nerve can be stimulated via the needle through which the catheter is placed, or via both the needle and the catheter itself. This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) and retrospective analysis, in order to determine the efficacy of continuous femoral nerve block comparing the use of stimulating catheters with non-stimulating catheters for lower-extremity surgery. Furthermore, we explore the adjunctive use of ultrasonography for femoral nerve block.

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“…Neue technische Entwicklungen wie ultraschallgezielte Katheterplatzierungen und Stimulationskatheter haben die Präzision dieser Techniken sehr verbessert und liefern auch die Mög-lichkeit der Kontrolle und Dokumentation der korrekten Katheterlage [8, 22,24]. Bei Stimulationskathetern wird zunächst eine Hohlnadel mit elektrisch leitender Spitze und isoliertem Schaft in üblicher Technik nervennah platziert.…”

Section: Schmerztherapie Mit Stimulationskathetern Bei Kniegelenkersaunclassified

Schmerztherapie mit Stimulationskathetern bei Kniegelenkersatz

Fritze

Anderl

Marouf

et al. 2009

Schmerz

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Continuous Peripheral Nerve Blocks With Stimulating Catheters

Cited by 77 publications

References 10 publications

Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block: an ex vivo study

Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block: an ex vivo study

Efficacy of Continuous Femoral Nerve Block with Stimulating Catheters Versus Nonstimulating Catheters - A Systematic-Narrative Review

Schmerztherapie mit Stimulationskathetern bei Kniegelenkersatz

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