Decreasing leakage during continuous femoral nerve catheter fixation using 2-octyl cyanoacrylate glue (Dermabond®): a randomized controlled trial

Abstract

Background Continuous 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. Methods Thirty 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. Results The 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. Conclusions Catheter 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 registration This trial was registered on Thai clinical trial registry: TCTR20200228002, registered 24 February 2020- Retrospectively registered.

Reduction of leakage from insertion site during continuous femoral nerve block with catheter-through-needle versus catheter-over-needle technique for postoperative analgesia after total knee arthroplasty: a randomized controlled trial

“…One of the problems in performing CPNB is the leakage of local anesthetic from the catheter insertion site. The use of glue at the puncture site [ 8 , 16 ] and tunneling of catheters [ 17 ] have been reported to be effective in preventing leakage; however, both of these methods require extra costs and invasive procedures.…”

Engineered Hemostatic Biomaterials for Sealing Wounds

“…Synthetic approaches, where materials are developed with molecularly designed macromolecular backbones, enable control over the physical and chemical properties of the hydrogel such as swelling, charge, etc. Synthetic hydrogel-based internal hemostatic sealants for cardiac reconstruction and pulmonary repair have been commercialized and developed based on PEG (e.g., CoSeal, Progel, and Tridyne) and cyanoacrylates (Dermabond) as well as natural components such as gelatin (Floseal), BSA (BioGlue), and fibrinogen (Tisseel and Evicel) . Recently, Quan et al reported strategies to design hemostatic biomaterials through cross-linking 2,3-diaminopropionic acid (DapA) with a graphene oxide (GO) sponge, as shown in Figure .…”