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Abstract
Background and Aims We report an unusual catheter related complication that led to the failure of a continuous infraclavicular block. Informed written consent was obtained prior to writing this abstract.
Methods A 39 year-old lady with CRPS of the left upper limb had a Pajunk® stimulating catheter inserted and tunneled, under dual guidance, in the infraclavicular brachial plexus. The purpose of the block was to provide analgesia, in an ambulatory setting, for 3 weeks whilst the patient underwent ultrasound-guided dry needling daily. On the 13th day, patient reported unsatisfactory pain relief overnight. On examination, the entry and exit wounds were clean and the catheter remained at the 16cm mark where it had been originally placed – no dislodgement. Injection of a saline bolus revealed a spurt of fluid from the catheter, at a breakage point, generating a leak.
The catheter was cut ahead of the break and the filter and dock reconnected. A saline bolus was re-administered to confirm the absence of any leak and Ultrasound visualization of drug spread around the brachial plexus was also seen. The dressing was reapplied and infusion of local anaesthetic mixture restarted.
Results On review the next day, the patient reported good pain relief. The catheter was removed a week later without any further complications with catheter tip culture showing no growth
Conclusions We surmise that the catheter wall might have been faulty and hence developed a hole in the portion secured beneath the sterile adhesive dressing (opsiteÒ). We have not encountered this problem in any of our previous 42 cases