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Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques

BACKGROUND: Epidural analgesia failure episodes can be reduced by catheter fixation techniques with a lower incidence of catheter migration. In this clinical study, we compared the roles of two epidural catheter tunneling techniques for the prevention of epidural catheter migration. METHODS: Patient...

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Autores principales: Gautam, Sujeet, Agarwal, Anil, Das, Pravin Kumar, Khuba, Sandeep, Kumar, Sanjay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Anesthesiologists 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862929/
https://www.ncbi.nlm.nih.gov/pubmed/32668834
http://dx.doi.org/10.4097/kja.20131
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author Gautam, Sujeet
Agarwal, Anil
Das, Pravin Kumar
Khuba, Sandeep
Kumar, Sanjay
author_facet Gautam, Sujeet
Agarwal, Anil
Das, Pravin Kumar
Khuba, Sandeep
Kumar, Sanjay
author_sort Gautam, Sujeet
collection PubMed
description BACKGROUND: Epidural analgesia failure episodes can be reduced by catheter fixation techniques with a lower incidence of catheter migration. In this clinical study, we compared the roles of two epidural catheter tunneling techniques for the prevention of epidural catheter migration. METHODS: Patients undergoing major abdominal surgery were randomized into three groups of 50 patients each based on the method used to secure the epidural catheter. In the control group (CG), the epidural catheter was secured without tunneling. Tunneling groups 1 and 2 (TG1 and TG2) were defined as tunneling with and without a catheter loop, respectively. The primary outcome measure was the migration of the epidural catheter, while the secondary outcome measures were the adequacy of analgesia and signs of inflammation. All patients were followed up by the acute pain service team twice daily in the postoperative period until the epidural catheter was removed. The results were analyzed by the one-way analysis of variance (ANOVA), chi-square test, and Fisher’s exact test. P values <0.05 were considered significant. RESULTS: The three groups were similar with respect to patient characteristics. Catheter migration was significantly reduced in TG2 (two patients) compared to those in the other two groups, i.e., TG1 (eight patients) (P = 0.045) and CG (17 patients) (P = 0.001). No differences were found amongst the three groups in analgesia adequacy and catheter site inflammation (P > 0.05). CONCLUSIONS: Catheter migration was significantly reduced by tunneling without a catheter loop in TG2 as compared to the other two groups. Therefore, we suggest routine use of tunneling without a catheter loop technique in anesthesia practice and look forward to future studies with larger sample sizes.
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spelling pubmed-78629292021-02-10 Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques Gautam, Sujeet Agarwal, Anil Das, Pravin Kumar Khuba, Sandeep Kumar, Sanjay Korean J Anesthesiol Clinical Research Article BACKGROUND: Epidural analgesia failure episodes can be reduced by catheter fixation techniques with a lower incidence of catheter migration. In this clinical study, we compared the roles of two epidural catheter tunneling techniques for the prevention of epidural catheter migration. METHODS: Patients undergoing major abdominal surgery were randomized into three groups of 50 patients each based on the method used to secure the epidural catheter. In the control group (CG), the epidural catheter was secured without tunneling. Tunneling groups 1 and 2 (TG1 and TG2) were defined as tunneling with and without a catheter loop, respectively. The primary outcome measure was the migration of the epidural catheter, while the secondary outcome measures were the adequacy of analgesia and signs of inflammation. All patients were followed up by the acute pain service team twice daily in the postoperative period until the epidural catheter was removed. The results were analyzed by the one-way analysis of variance (ANOVA), chi-square test, and Fisher’s exact test. P values <0.05 were considered significant. RESULTS: The three groups were similar with respect to patient characteristics. Catheter migration was significantly reduced in TG2 (two patients) compared to those in the other two groups, i.e., TG1 (eight patients) (P = 0.045) and CG (17 patients) (P = 0.001). No differences were found amongst the three groups in analgesia adequacy and catheter site inflammation (P > 0.05). CONCLUSIONS: Catheter migration was significantly reduced by tunneling without a catheter loop in TG2 as compared to the other two groups. Therefore, we suggest routine use of tunneling without a catheter loop technique in anesthesia practice and look forward to future studies with larger sample sizes. Korean Society of Anesthesiologists 2021-02 2020-07-16 /pmc/articles/PMC7862929/ /pubmed/32668834 http://dx.doi.org/10.4097/kja.20131 Text en © The Korean Society of Anesthesiologists, 2021 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Gautam, Sujeet
Agarwal, Anil
Das, Pravin Kumar
Khuba, Sandeep
Kumar, Sanjay
Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques
title Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques
title_full Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques
title_fullStr Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques
title_full_unstemmed Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques
title_short Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques
title_sort prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862929/
https://www.ncbi.nlm.nih.gov/pubmed/32668834
http://dx.doi.org/10.4097/kja.20131
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