Portex Epifuse™ connector blockages

Evans, Rupert; Baraz, Rafal; Joseph, Anna

doi:10.1111/j.1365-2044.2012.07079_4.x

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…Visual inspection following disconnection revealed that an insufficient length of catheter had been inserted into the connector. Recent case reports [13, 14] have suggested that the EpiFuse lumen may rarely be prone to occlusion following repeated clamping and unclamping, thereby preventing adequate catheter insertion. In our study, all catheters were patent to air following assembly, thus the likely cause of the failed connection remains as operator error.…”

Section: Discussionmentioning

confidence: 99%

“…This may have contributed to the paradoxical increase in number of disconnections observed following introduction of the EpiFuse into clinical practice [12]. Subsequently, concerns have also been raised regarding lumen patency on repeated opening and closing [13, 14]. We therefore hypothesised that forcibly unlocking the connector may adversely affect patency of the EpiFuse lumen or strength of its locking mechanism.…”

mentioning

confidence: 99%

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Epidural catheter connectors: a laboratory‐based comparison of the Portex Tuohy‐Borst and EpiFuse™ designs^*

Richardson¹,

Turner

Wilkes

2012

Anaesthesia

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SummaryDisconnection of an epidural catheter from its connector may result in patient harm and commonly requires resiting of the epidural. Clamp-connector designs such as the novel Portex EpiFuse TM potentially offer an improved safety profile over screw-cap designs such as the Tuohy-Borst, but comparative studies are limited. We therefore compared the tensile strength of EpiFuse and Tuohy-Borst connectors in a laboratory setting. We further sought to establish whether operator modification of the EpiFuse increased its vulnerability to disconnection. The median (IQR

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Epidural catheter connectors: a laboratory‐based comparison of the Portex Tuohy‐Borst and EpiFuse™ designs^*

Richardson¹,

Turner

Wilkes

2012

Anaesthesia

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“…Although accidental epidural catheter dislodgement and disconnection are minor complications, they could be associated with the catheter itself rather than patient-or staff-related factors. Indeed, catheter-related accidental removal has been previously reported, following product design changes [5][6][7][8][9][10]. In 2016, the international standard ISO 80369-6 was published to help prevent neuraxial drug administration errors; the guideline recommended a non-Luer neuraxial connector design, which has become the new standard [11].…”

Section: Introductionmentioning

confidence: 99%

Accidental Epidural Catheter Removal Rates and Strength Required for Disconnection: a Retrospective Cohort and Experimental Study

Ishida

Homma

Kawamura

et al. 2021

Preprint

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Background: Epidural analgesia requires the use of epidural catheters, which are associated with certain risks such as accidental epidural catheter removal, including dislodgement and disconnection. Few studies have investigated accidental catheter removal rates and directly compared them among epidural connector types. This study aimed to examine the differences in accidental catheter removal rates associated with different catheter connector types and to experimentally determine the linear tensile strength required to induce disconnection in each connector type.Methods: This retrospective cohort study included adult patients who underwent elective surgery and received patient-controlled epidural analgesia between December 2019 and August 2020. Patients were divided into groups according to the type of catheter connection used: standard (old group), new standard (new group), and new standard with taping (taping group). Furthermore, we prepared 60 sets of epidural catheters and connectors comprising 20 sets for each of the old, new, and taping groups, and used the digital tension meter to measure the maximum tensile strength required to induce disconnection. A multinomial logistic regression analysis was used to examine risk factors for disconnection. The experimental study groups were compared using one-way analysis of variance.Results: The clinical study involved in 920 patients (360, 182, and 378 patients in the old, new, and taping group, respectively). Dislodgement rates were similar among the three groups. Disconnection was most likely to occur in the new group (5.5%) and least likely to occur in the taping group (0.3%) compared to the old group (1.9%). However, the new group was not a risk factor for disconnection. The experimental study identified tensile strengths of 12.41 N, 12.06 N, and 19.65 N in the old, new, and taping groups, respectively. Comparison tests showed a significant difference in the tensile strength required for disconnection between the new and taping groups but not between the new and old groups.Conclusions: These findings suggest that taping the catheter connector connection may reduce the risk of disconnection, and thereby help improve patient outcomes. Further studies are required to clarify other parameters that may affect patient safety in this context.

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“…I read with interest your correspondence relating to problems encountered with the Portex Epifuse ™ epidural catheter connector . I would like to share with readers a potential solution to the difficulties encountered with opening the device.…”

mentioning

confidence: 99%

“…Obviously, a proper RCT would address the effectiveness and safety of CSF lavage; however, since the method is usually only performed in emergency situations, such a trial would be difficult to perform and unlikely to be published in the near future. While one must exercise caution before accepting the benefits of a new treatment and applying it clinically based only on case reports [5], perhaps we should reconsider the risks and benefits of CSF lavage from a common sense perspective. Indeed, as in the 'parachute' argument [6], some believe that the benefits of certain treatments or interventions are obvious despite a lack of RCT evidence.…”

mentioning

confidence: 99%

Opening Portex Epifuse^TM connectors

Rippin

2014

Anaesthesia

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Portex Epifuse™ connector blockages

Cited by 5 publications

References 2 publications

Epidural catheter connectors: a laboratory‐based comparison of the Portex Tuohy‐Borst and EpiFuse™ designs^*

Epidural catheter connectors: a laboratory‐based comparison of the Portex Tuohy‐Borst and EpiFuse™ designs^*

Accidental Epidural Catheter Removal Rates and Strength Required for Disconnection: a Retrospective Cohort and Experimental Study

Opening Portex Epifuse^TM connectors

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Portex Epifuse™ connector blockages

Cited by 5 publications

References 2 publications

Epidural catheter connectors: a laboratory‐based comparison of the Portex Tuohy‐Borst and EpiFuse™ designs*

Epidural catheter connectors: a laboratory‐based comparison of the Portex Tuohy‐Borst and EpiFuse™ designs*

Accidental Epidural Catheter Removal Rates and Strength Required for Disconnection: a Retrospective Cohort and Experimental Study

Opening Portex EpifuseTM connectors

Contact Info

Product

Resources

About

Epidural catheter connectors: a laboratory‐based comparison of the Portex Tuohy‐Borst and EpiFuse™ designs^*

Epidural catheter connectors: a laboratory‐based comparison of the Portex Tuohy‐Borst and EpiFuse™ designs^*

Opening Portex Epifuse^TM connectors