Tips and tricks to facilitate ultrasound‐guided placement of peripheral nerve catheters in children

Abstract

Continuous peripheral nerve blocks in children should be placed under US guidance in LAX whenever possible, with a three-hand technique and slightly withdrawing or rotating the needle tip to introduce the catheter, administering LA through the catheter, and performing subcutaneous tunneling and careful dressing.

Postoperative pain management in children: Guidance from the pain committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative)

“…If using a double block consider the total amount of local anesthetic. [198][199][200][201][202] • If PNB is contraindicated: fentanyl or opioid of choice in divided doses.…”

A comparison of strength for two continuous peripheral nerve block catheter dressings

“…Finally, we only tested two dressing and securement strategies, both involving clear adhesive dressing; thus, the results of this study are specific to the techniques and materials tested. We do not speculate on how other methods, such as tunneling, and application of liquid adhesives or surgical tape, among others [ 5 6 ], may have performed either alone or in combination. Previous publications have asserted that a combination of several methods may lead to successful perineural catheter retention for a week or longer [ 4 10 11 12 ].…”

“…While many perineural catheter dressing and securement strategies have been described, including tunneling, topical skin adhesive, sterile tape, clear adhesive dressings, and anchoring devices [ 1 4 5 6 ], rigorous head-to-head comparisons of these strategies have not been reported. Thus, the optimal perineural catheter dressing strategy to ensure reliable infusion of local anesthetic for the desired duration remains unknown.…”

A Short Report of the First Use of Catheter-over-Needle System (Contiplex^®C) for Continuous Peripheral Nerve Block Placement in Children in the UK

“…CPNBs are one of the most promising developments in regional anaesthesia [1] and gaining in popularity [2] June 2014 | Volume 1 | e723 however catheter placement can be technically challenging, especially in children [3] [4]. Difficulties may occur during introduction of catheter, catheter tip visualization (if ultrasound-guided technique is used), and catheter fixation [3]. After their placement, mechanical problems such as accidental withdrawal, occlusion and leakage at catheter sites may occur [5].…”