Incidence of Suture-Method Catheter Dislocation with Femoral Nerve Block and Femoral Triangle Block after Total Knee Arthroplasty

Abstract

Catheter dislocation with continuous peripheral nerve blocks represents a major problem in clinical settings. There is a range of factors affecting the incidence of catheter dislocation, including catheter type. This study aimed to assess the incidence of suture-method catheter (SMC) dislocation 24 h after total knee arthroplasty (TKA), with continuous femoral nerve block (CFNB) and continuous femoral triangle block (CFTB), respectively. In the prospective randomized trial, 40 patients qualified for TKA with SMC and were divided into two groups, those who received CFNB (Group 1, n = 20) and those who received CFTB (Group 2, n = 20). After 24 h, the degree of catheter displacement (cm), pain intensity (NRS) and opioid consumption (mg) was assessed. The catheter dislocation rates were found to be 15% in Group 1 versus 5% in Group 2, with the catheter dislocated by 0.83 cm (SD = ±0.87) and 0.43 cm (SD = ±0.67), respectively. There were no differences in NRS score (p = 0.86) or opioid consumption (p = 0.16) between the groups. In each case, a displaced catheter was successfully repositioned by pulling, which clinically resulted in a lower NRS score. The results of the study suggest that CFTB with SMC may be used after TKA with a good effect, as it is associated with low catheter dislocation rates and an adequate analgesic effect.

Migration rate of proximal adductor canal block catheters placed parallel versus perpendicular to the nerve after total knee arthroplasty: a randomized controlled study

“…Also, suture-method catheters could better stay in situ than usual block catheters even with the perpendicular placement. 15 Fifth, the average body mass index of this study participants could be smaller than that of similar patient populations in other countries. A bigger body habitus may make parallel catheter placement more difficult.…”

Continuous peripheral nerve blocks for analgesia following painful ambulatory surgery: a review with focus on recent developments in infusion technology

“…Purported benefits of this catheter delivery system included more precise placement of the orifice adjacent to the target nerve, the ability to readjust the catheter orifice position after initial placement, and lower risk of dislodgement because of the two (entry and exit) sites at which it was secured [22 ▪ ]. However, this latter technique did not improve analgesia over the more conventional insertion methods and has yet to be described in more than a few reports [25]. Thus, catheter-through-needle and catheter-over-needle remain the common methods for insertion of perineural catheters.…”