Article Text

Download PDFPDF

EP182 Reducing local anaesthetic catheter displacements: A bench top study of optimum means of catheter fixation
  1. Emily Tulloch,
  2. James Winchester,
  3. Paul Douglass and
  4. Nick Suarez
  1. Anaesthetics, NHS, Oxford, UK


Background and Aims Local anaesthesia (LA) nerve infusions are increasingly used in our institution for rib fracture analgesia; they provide not only excellent analgesia but reduce morbidity, mortality and improve economic outcomes [1]. Data from a local audit demonstrated 33% of rib fracture LA infusions were prematurely removed due to accidental disconnection. Currently there is no consensus on the optimum method of securing LA catheters in place [2]. Accordingly, we aimed to reduce rates of catheter disconnection through a benchtop experiment to determine the optimal LA catheter fixation method.

Methods We used a porcine abdominal wall model (figure 1) to determine the force required to displace catheters secured using seven methods (table 1). We used our in-service wingless catheter-through-needle system (Pajunk), except when examining suturing strength, where a Vygon arterial line with suturing wings was used. The force required to displace the catheter by 1cm from the skin was measured. Each method was repeated 5 times. Data was analysed using parametric tests.

Results Catheters secured using Tegaderm and Dermabond (13.04 N, p=0.0004), Epifix and Dermabond (11.18 N, p=0.007) and Tegaderm and suturing (42.18 N, p=0.001) required significantly more force to displace than those using Tegaderm alone (5.94 N)(figure 2).

Abstract EP182 Table 1

A table demonstrating different methods used to secure local anaesthetic catheters in situ, using a porcine abdominal wall model

Abstract EP182 Figure 1

Photographs depicting local anaesthetic catheter fixation methods, in situ, on a porcine abdominal wall model

Abstract EP182 Figure 2

A bar chart illustrating the mean force (newtons) required to displace local anaesthetic catheters secured on a porcine abdominal wall model using different methods of fixation. Error bars represent +/- 1 standard deviation. Statistical significance was analysed with ANOVA and post hoc t-tests (*P<0.01)

Conclusions Tegaderm with suturing was the most effective method of catheter fixation, requiring a force several times that required to displace catheters secured using other means. However, Tegaderm and Dermabond provide effective fixation while also being both more cost-effective and patient/operator friendly. Consequently, we changed our department’s catheter fixation policy to advocate routine use of skin glue.

  • Anaesthesia
  • analgesia
  • Local anaesthetic
  • peripheral nerve blocks
  • nerve infusion catheters
  • fixation

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.