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

Hattammaru, Yoshiyasu; Mio, Yasushi; Hascilowicz, Tomasz; Utsumi, Isao; Murakami, Yûichi; Omi, Sachiko

doi:10.1186/s12871-021-01554-9

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…Thus, catheterthrough-needle and catheter-over-needle remain the common methods for insertion of perineural catheters. Investigations comparing these two catheter insertion techniques have generally found them to be similar with regard to analgesic and opioidsparing effects, while catheter-over-needle techniques produce slightly less leakage of local anesthetic at the catheter insertion site [26][27][28][29][30].…”

Section: History and Evolution Of Ambulatory Continuous Peripheral Ne...mentioning

confidence: 99%

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

Finneran

2023

Current Opinion in Anaesthesiology

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Purpose of review Continuous peripheral nerve blocks (cPNB) decrease pain scores and opioid consumption while improving patient satisfaction following ambulatory surgery. This review focuses on the history and evolution of ambulatory cPNBs, recent developments in infusion technology that may prolong the duration of analgesia, optimal choice of cPNB for various surgical procedures, and novel analgesic modalities that may prove to be alternatives or supplements to cPNBs. Recent findings The primary factor limiting the duration of an ambulatory cPNB is the size of the local anesthetic reservoir. Recent evidence suggests the use of automated boluses, as opposed to continuous infusions, may decrease the rate of consumption of local anesthetic and, thereby, prolong the duration of analgesia. Utilizing a long-acting local anesthetic (e.g. ropivacaine) for initial block placement and an infusion start-delay timer may further increase this duration. Summary Patients undergoing painful ambulatory surgery are likely to have less pain and require fewer opioid analgesics when receiving a cPNB for postoperative analgesia. Advances in electronic pumps used for cPNBs may increase the duration of these benefits.

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Section: History and Evolution Of Ambulatory Continuous Peripheral Ne...mentioning

confidence: 99%

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

Finneran

2023

Current Opinion in Anaesthesiology

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Assessment of catheter position using chest CT in adults undergoing erector spinae plane analgesia for rib fractures: a retrospective cohort study

Wu,

Barrak,

Forrest

et al. 2024

Reg Anesth Pain Med

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BackgroundContinuous erector spinae plane (ESP) analgesia is a common adjuvant for patients with traumatic rib fracture pain and success relies on the ESP catheter remaining within the correct fascial plane for the duration of its placement. However, knowledge on postplacement position of indwelling ESP catheters is largely absent. We hypothesized that migration of over-the-needle ESP catheters was common and detectable with coincidental postprocedure CT.MethodsIn this single-center retrospective cohort study, adults admitted to the surgical intensive care unit for traumatic rib fractures between January 2020 and July 2022 were screened. Those receiving continuous ESP analgesia via indwelling catheter and undergoing subsequent chest CT were included. The primary outcome was the proportion of catheters that migrated outside the ESP. The secondary outcome was the distance between the catheter tip and the nearest transverse process (TP) or fascial plane.Results160 medical records were screened for eligibility and 15 patients (18 catheters) met the inclusion criteria. 16 of 18 catheters reviewed were found outside the ESP. Furthermore, catheter position was reported as intramuscular in 14 catheters and subcutaneous in 4 catheters. The median distance between catheter tip and the nearest TP (or the ESP) was 23.20 mm sagittally and 25.05 mm axially.ConclusionsMost ESP catheters were found superficial to the fascial plane in the days following their placement. The median distance between the catheter and the ESP is between 23 and 25 mm. Prospective studies should address catheter migration concerns and propose solutions to this common issue.

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A proof-of-concept study of ultrasound-guided continuous parasacral ischial plane block for postoperative pain control in patients undergoing total knee arthroplasty

Ye,

Zheng,

Gong

et al. 2024

J Orthop Surg Res

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Background Continuous peripheral nerve blocks are widely used for anesthesia and postoperative analgesia in lower limb surgeries. The authors aimed to develop a novel continuous sacral plexus block procedure for analgesia during total knee arthroplasty. Methods The study comprised two stages. In Stage I, the authors built upon previous theories and technological innovations to develop a novel continuous sacral plexus block method, ultrasound-guided continuous parasacral ischial plane block (UGCPIPB) and subsequently conducted a proof-of-concept study to assess its effectiveness and feasibility. Stage II involved a historical control study to compare clinical outcomes between patients undergoing this new procedure and those receiving the conventional procedure. Results The study observed a 90% success rate in catheter placement. On postoperative day (POD) 1, POD2, and POD3, the median visual analog scale (VAS) scores were 3 (range, 1.5–3.5), 2.5 (1.6–3.2), and 2.7 (1.3–3.4), respectively. Furthermore, 96.3% of the catheters remained in place until POD3, as confirmed by ultrasound. The study revealed a significant increase in skin temperature and peak systolic velocity of the anterior tibial artery on the blocked side compared with those on the non-blocked side. Complications included catheter clogging in one patient and leakage at the insertion site in two patients. In Stage II, the novel technique was found to be more successful than conventional techniques, with a lower catheter displacement rate than the conventional procedure for continuous sciatic nerve block. Conclusion UGCPIPB proved to be an effective procedure and safe for analgesia in total knee arthroplasty. Chinese Clinical Trial Registry Number ChiCTR2300068902.

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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

Cited by 4 publications

References 17 publications

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

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

Assessment of catheter position using chest CT in adults undergoing erector spinae plane analgesia for rib fractures: a retrospective cohort study

A proof-of-concept study of ultrasound-guided continuous parasacral ischial plane block for postoperative pain control in patients undergoing total knee arthroplasty

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