Journal of Research & Innovation in Anesthesia

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VOLUME 2 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL RESEARCH

A Prospective, Randomized Study comparing the Efficacy and Safety of Adhesive Strip (Steri-Strips™) Fixation vs Subcutaneous Tunneling for securing Epidural Catheters in Pediatric Patients

Madhu Garasia, Ketan S Kulkarni, Nandini M Dave, Shriyam S Kulkarni, Shivani Shinde, Indrani Chincholi

Citation Information : Garasia M, Kulkarni KS, Dave NM, Kulkarni SS, Shinde S, Chincholi I. A Prospective, Randomized Study comparing the Efficacy and Safety of Adhesive Strip (Steri-Strips™) Fixation vs Subcutaneous Tunneling for securing Epidural Catheters in Pediatric Patients. Res Inno in Anesth 2017; 2 (2):40-44.

DOI: 10.5005/jp-journals-10049-0031

License: CC BY 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Effective epidural catheter fixation is a key aspect of postoperative pain management in pediatric patients. We conducted a prospective, randomized study comparing the efficacy and safety of adhesive strip (Steri-Strips™) vs subcutaneous tunneling for successful epidural catheter fixation.

Materials and methods

American Society of Anesthesiologists (ASA) grades I and II patients between the age group of 1 day and 12 years were included in the study. The parameters studied were inward and outward migration, and dislodgment of catheter. Erythema, induration, catheter snapping, catheter obstruction, total duration of epidural infusion, and catheter tip culture were also recorded. Feedback from the operator for ease of fixation technique was noted and reviewed.

Results

This study was performed in 64 patients posted for various abdominal, thoracic, and genital surgeries, requiring postoperative epidural analgesia. The epidural catheter was successfully placed in the first attempt in 61 patients. Outward migration was seen in six patients with Steri-Strips-taped catheters and in one patient with a tunneled catheter. Accidental removal was done in five patients with tunneled catheters and one patient with strip-taped catheter. Rescue analgesics were required in these patients. No inward migration of catheter was seen in both the groups. Bleeding from tunneling site was seen in five patients.

Conclusion

In comparison with a tunneling technique for epidural catheter fixation, a simple method of applying Steri-Strips™ to epidural catheters significantly reduces the incidence of accidental removal.

How to cite this article

Kulkarni KS, Dave NM, Kulkarni SS, Nataraj G, Shinde S, Chincholi I, Garasia M. A Prospective, Randomized Study comparing the Efficacy and Safety of Adhesive Strip (Steri-Strips™) Fixation vs Subcutaneous Tunneling for securing Epidural Catheters in Pediatric Patients. Res Inno in Anesth 2017;2(2):40-44.


  1. Epidural catheter migration: a comparison of tunnelling against a new technique of catheter fixation. Anaesth Intensive Care 2003 Oct;31(5):518-522.
  2. Intrapartum epidural catheter migration: a comparative study of three dressing applications. Br J Anaesth 2001 Apr;86(4):565-567.
  3. The effect of the Lockit epidural catheter clamp on epidural migration: a controlled trial. Anaesthesia 2001 Sep;56(9):865-870.
  4. The effect of tunnelling on epidural catheter migration. Anaesthesia 1996 Feb;51(2):191-194.
  5. Subcutaneous tunnelling of epidural catheters for postoperative analgesia to prevent accidental dislodgement: a randomized controlled trial. Anaesth Intensive Care 1998 Apr;26(2):147-151.
  6. Factors influencing epidural catheter migration. Anaesthesia 1992 Jul;47(7):610-612.
  7. Migration of thoracic epidural catheters. Three methods for evaluation of catheter position in the thoracic epidural space. Anaesthesia 1989 Jul;44(7):574-577.
  8. Epidural catheter fixation: subcutaneous tunnelling with a loop to prevent displacement. Anaesthesia 2000 Nov;55(11):1113-1116.
  9. Epidural catheter fixation. A comparison of subcutaneous tunneling versus device fixation technique. J Anaesthesiol Clin Pharmacol 2016 Jan-Mar;32(1):65-68.
  10. Pediatric caudal epidural catheter sequestration: an unusual complication. Anesthesiology 1995 Nov;83(5):1112-1114.
  11. Breakage of epidural catheters: etiology, prevention, and management. Rev Bras Anestesiol 2008 May-Jun;58(3):227-233.
  12. Tunneling and suture of thoracic epidural catheters decrease the incidence of catheter dislodgement. Sci World J 2014 Jul;2014:610635.
  13. Subcutaneous tunneling of caudal catheters reduces the rate of bacterial colonization to that of lumbar epidural catheters. Anesth Analg 2004 Sep;99(3):689-693.
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