Decreasing leakage during continuous femoral nerve catheter fixation using 2-octyl cyanoacrylate glue (Dermabond®): a randomized controlled trial

Abstract Background Continuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief. A common problem encountered with CPNCs is pericatheter leakage, which can lead to dressing adhesive failure. Frequent dressing changes increase the risk of catheter dislodgement and infections. Adhesive glue is effective in securing the peripheral nerve catheter and decreasing leakage around the catheter insertion site. This study aimed to evaluate the incidence of pericatheter leakage with fixation using 2-octyl cyanoacrylate glue (Dermabond®) as compared to sterile strips. Methods Thirty patients undergoing unilateral total knee arthroplasty (TKA) with continuous femoral nerve catheter for postoperative analgesia were randomized into the catheter fixation with 2-octyl cyanoacrylate glue (Dermabond®) group or the sterile strip group. The primary outcome was the incidence of pericatheter leakage. Secondary outcomes included the frequent of catheter displacement, the difficulty of catheter removal, pain score and patient satisfaction. Results The incidence of pericatheter leakage at 24 and 48 h was 0% versus 93 and 0% versus 100% in the Dermabond® and sterile strip groups, respectively (P < 0.001). The incidence of displacement at 24 and 48 h was 6.7% versus 93.3 and 6.7% versus 100% in the Dermabond® and sterile strip, respectively (P < 0.001). There was no difference in numeric rating scale, difficulty of catheter removal, or satisfaction scores between groups. Conclusions Catheter fixation with 2-octyl cyanoacrylate glue (Dermabond®) decreased the incidence of pericatheter leakage, as well as catheter displacement, over 48 h as compared to sterile strip fixation. Trial registration This trial was registered on Thai clinical trial registry: TCTR20200228002, registered 24 February 2020- Retrospectively registered.

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Decreasing the leakage of continuous femoral nerve catheter fixation using 2-octyl cyanoacrylate glue (Demabond®): A randomized controlled trial

10.21203/rs.3.rs-41791/v4 ◽

2021 ◽

Author(s):

Theerawat Chalacheewa ◽

Vanlapa Arnuntasupakul ◽

Lisa Sangkum ◽

Rungrawan Buachai ◽

Jiravud Chanvitayapongs

Keyword(s):

Peripheral Nerve ◽

Rating Scale ◽

Controlled Trial ◽

Insertion Site ◽

Femoral Nerve ◽

Numeric Rating Scale ◽

Catheter Removal ◽

Cyanoacrylate Glue ◽

Catheter Dislodgement ◽

Peripheral Nerve Catheter

Abstract Background: Continuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief. A common problem encountered with CPNCs is pericatheter leakage, which can lead to dressing adhesive failure. Frequent dressing changes increase the risk of catheter dislodgement and infections. Adhesive glue is effective in securing the peripheral nerve catheter and decreasing leakage around the catheter insertion site. This study aimed to evaluate the incidence of pericatheter leakage with fixation using 2-octyl cyanoacrylate glue (Dermabond®) as compared to sterile strips.Methods: Thirty patients undergoing unilateral total knee arthroplasty (TKA) with continuous femoral nerve catheter for postoperative analgesia were randomized into the catheter fixation with 2-octyl cyanoacrylate glue (Dermabond®) group or the sterile strip group. The primary outcome was the incidence of pericatheter leakage. Secondary outcomes included the frequent of catheter displacement, the difficulty of catheter removal, pain score and patient satisfaction.Results: The incidence of pericatheter leakage at 24 and 48 hours was 0% versus 93% and 0% versus 100% in the Dermabond® and sterile strip groups, respectively (P < 0.001). The incidence of displacement at 24 and 48 hours was 6.7% versus 93.3% and 6.7% versus 100% in the Dermabond® and sterile strip, respectively (P < 0.001). There was no difference in numeric rating scale, difficulty of catheter removal, or satisfaction scores between groups.Conclusion: Catheter fixation with 2-octyl cyanoacrylate glue (Dermabond®) decreased the incidence of pericatheter leakage, as well as catheter displacement, over 48 hours as compared to sterile strip fixation.

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Decreasing the leakage of continuous femoral nerve catheter fixation using 2 - octyl cyanoacrylate glue (Demabond®): A Randomized Controlled Trial study

10.21203/rs.3.rs-41791/v3 ◽

2020 ◽

Author(s):

Theerawat Chalacheewa ◽

Vanlapa Arnuntasupakul ◽

Lisa Sangkum ◽

Rungrawan Buachai ◽

jiravud Chanvitayapongs

Keyword(s):

Peripheral Nerve ◽

Rating Scale ◽

Controlled Trial ◽

Insertion Site ◽

Femoral Nerve ◽

Numeric Rating Scale ◽

Catheter Removal ◽

Cyanoacrylate Glue ◽

Catheter Dislodgement ◽

Peripheral Nerve Catheter

Abstract Background: Continuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief. A common problem encountered with CPNCs is pericatheter leakage which can lead to dressing adhesive failure. Frequent dressing changes increase the risk of catheter dislodgement and infections. Adhesive glue is effective in securing peripheral nerve catheter and decreasing leakage around the catheter insertion site. This study is aimed to evaluate the incidence of pericatheter leakage by using fixation with 2-octyl cyanoacrylate glue (Demabond®) compared to sterile strip.Methods: Thirty patients undergoing unilateral total knee arthroplasty (TKA) with continuous femoral nerve catheter for postoperative analgesia were randomized to catheter fixation with 2-octyl cyanoacrylate glue (Demabond®) group or sterile strip group. The primary outcome was the incidence of pericatheter leakage. Secondary outcomes included: frequent of catheter displacement, difficulty of catheter removal, pain score and patient satisfaction.Results: The incidence of pericatheter leakage at 24 and 48 hours was 0% versus 93% and 0% versus 100% in the Demabond and sterile strip group, respectively (P < 0.001). The incidence of displacement at 24 and 48 hours was 6.7% versus 93.3% and 6.7% versus 100%, respectively (P < 0.001). There was no difference in numeric rating scale, difficulty of catheter removal as well as satisfaction scores between groups.Conclusion: Catheter fixation with 2-octyl cyanoacrylate glue (Demabond®) decreased the incidence of pericatheter leakage as well as catheter displacement over 48 hours when compared to sterile strip fixation.

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Decreasing the leakage of continuous femoral nerve catheter fixation using 2 - octyl cyanoacrylate glue ( Demabond® ): A Randomized Controlled Trial study

10.21203/rs.3.rs-41791/v2 ◽

2020 ◽

Author(s):

Theerawat Chalacheewa ◽

Vanlapa Arnuntasupakul ◽

Lisa Sangkum ◽

Rungrawan Buachai

Keyword(s):

Peripheral Nerve ◽

Rating Scale ◽

Femoral Nerve Block ◽

Controlled Trial ◽

Femoral Nerve ◽

Catheter Removal ◽

Control Group ◽

Cyanoacrylate Glue ◽

Peripheral Nerve Catheter ◽

Perineural Catheter

Abstract Background : Continuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief. The common problem with CPNCs is pericatheter leakage that can compromise the sterile dressing, un-necessitating frequent dressing that may increase the risk of dislodgement and perineural catheter colonization or infections. Adhesive glue is useful for fixing peripheral nerve catheter as well as prevent leakage around the puncture site. This study aimed to evaluate the incidence of pericatheter leakage by using fixation with 2 -octyl cyanoacrylate glue (Demabond) compared to sterile strip. Methods : Thirty patients undergoing unilateral total knee arthroplasty and received continuous femoral nerve block were randomized to perineural catheter fixation with 2-octyl cyanoacrylate glue or sterile strip. The primary outcome was the incidence of pericatheter leakage. Secondary outcomes included frequent of catheter migration, difficulty of catheter removal, pain score and patient satisfaction. Results : The incidence of pericatheter leakage at 48 hours was 0% versus 100% in the intervention and control group. The incidence of displacement at 24 and 48 hours was 6.7% versus 93.3% and 6.7% versus 100%, respectively (P < 0.001). There was no difference in numeric rating scale, difficulty of catheter removal as well as satisfaction scores between groups. Conclusion : Catheter fixation with 2-octylcyanoacrylate reduced the incidence of pericatheter leakage as well as catheter displacement over 48 hours compare to sterile strip.

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Decreasing the Leakage of Continuous Femoral Nerve Catheter Fixation Using 2-octyl Cyanoacrylate Glue ( Demabond® ): A Randomized Controlled Trial Study

10.21203/rs.3.rs-41791/v1 ◽

2020 ◽

Author(s):

Vanlapa Arnuntasupakul ◽

Lisa Sangkum ◽

Rungrawan Buachai ◽

Theerawat Chalacheewa

Keyword(s):

Peripheral Nerve ◽

Rating Scale ◽

Femoral Nerve Block ◽

Controlled Trial ◽

Femoral Nerve ◽

Catheter Removal ◽

Control Group ◽

Cyanoacrylate Glue ◽

Peripheral Nerve Catheter ◽

Perineural Catheter

Abstract Background: Continuous peripheral nerve catheters (CPNCs) have been used for postoperative pain relief. The common problem with CPNCs is pericatheter leakage that can compromise the sterile dressing, un-necessitating frequent dressing that may increase the risk of dislodgement and perineural catheter colonization or infections. Adhesive glue is useful for fixing peripheral nerve catheter as well as prevent leakage around the puncture site. This study aimed to evaluate the incidence of pericatheter leakage by using fixation with 2-octyl cyanoacrylate glue (Demabond®) compared to sterile strip.Methods: Thirty patients undergoing unilateral total knee arthroplasty and received continuous femoral nerve block were randomized to perineural catheter fixation with 2-octyl cyanoacrylate glue or sterile strip. The primary outcome was the incidence of pericatheter leakage. Secondary outcomes included frequent of catheter migration, difficulty of catheter removal, pain score and patient satisfaction.Results: The incidence of pericatheter leakage at 48 hours was 0% versus 100% in the intervention and control group. The incidence of displacement at 24 and 48 hours was 6.7% versus 93.3% and 6.7% versus 100%, respectively (P < 0.001). There was no difference in numeric rating scale, difficulty of catheter removal as well as satisfaction scores between groups.Conclusion: Catheter fixation with 2-octylcyanoacrylate reduced the incidence of pericatheter leakage as well as catheter displacement over 48 hours compare to sterile strip.

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ACCELERATING AXON GROWTH TO OVERCOME LIMITATIONS IN FUNCTIONAL RECOVERY AFTER PERIPHERAL NERVE INJURY

Neurosurgery ◽

10.1227/01.neu.0000335650.09473.d3 ◽

2009 ◽

Vol 65 (suppl_4) ◽

pp. A132-A144 ◽

Cited By ~ 105

Author(s):

Tessa Gordon ◽

K. Ming Chan ◽

Olawale A.R. Sulaiman ◽

Esther Udina ◽

Nasim Amirjani ◽

...

Keyword(s):

Electrical Stimulation ◽

Peripheral Nerve ◽

Nerve Regeneration ◽

Controlled Trial ◽

Peripheral Nerve Regeneration ◽

Femoral Nerve ◽

Axon Growth ◽

Cyclic Adenosine Monophosphate ◽

Adenosine Monophosphate ◽

Clinical Tool

Abstract OBJECTIVE Injured peripheral nerves regenerate at very slow rates. Therefore, proximal injury sites such as the brachial plexus still present major challenges, and the outcomes of conventional treatments remain poor. This is in part attributable to a progressive decline in the Schwann cells' ability to provide a supportive milieu for the growth cone to extend and to find the appropriate target. These challenges are compounded by the often considerable delay of regeneration across the site of nerve laceration. Recently, low-frequency electrical stimulation (as brief as an hour) has shown promise, as it significantly accelerated regeneration in animal models through speeding of axon growth across the injury site. METHODS To test whether this might be a useful clinical tool, we carried out a randomized controlled trial in patients who had experienced substantial axonal loss in the median nerve owing to severe compression in the carpal tunnel. To further elucidate the potential mechanisms, we applied rolipram, a cyclic adenosine monophosphate agonist, to rats after axotomy of the femoral nerve. RESULTS We demonstrated that effects similar to those observed in animal studies could also be attained in humans. The mechanisms of action of electrical stimulation likely operate through up-regulation of neurotrophic factors and cyclic adenosine monophosphate. Indeed, the application of rolipram significantly accelerated nerve regeneration. CONCLUSION With new mechanistic insights into the influencing factors of peripheral nerve regeneration, the novel treatments described above could form part of an armament of synergistic therapies that could make a meaningful difference to patients with peripheral nerve injuries.

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Percutaneous Peripheral Nerve Stimulation (Neuromodulation) for Postoperative Pain: A Randomized, Sham-controlled Pilot Study

Anesthesiology ◽

10.1097/aln.0000000000003776 ◽

2021 ◽

Author(s):

Brian M. Ilfeld ◽

Anthony Plunkett ◽

Alice M. Vijjeswarapu ◽

Robert Hackworth ◽

Sandeep Dhanjal ◽

...

Keyword(s):

Postoperative Pain ◽

Peripheral Nerve ◽

Nerve Stimulation ◽

Treatment Effect ◽

Rating Scale ◽

Pulse Generator ◽

Femoral Nerve ◽

Opioid Consumption ◽

Peripheral Nerve Stimulation ◽

Pain Scores

Background Percutaneous peripheral nerve stimulation is an analgesic technique involving the percutaneous implantation of a lead followed by the delivery of electric current using an external pulse generator. Percutaneous peripheral nerve stimulation has been used extensively for chronic pain, but only uncontrolled series have been published for acute postoperative pain. The current multicenter study was undertaken to (1) determine the feasibility and optimize the protocol for a subsequent clinical trial and (2) estimate the treatment effect of percutaneous peripheral nerve stimulation on postoperative pain and opioid consumption. Methods Preoperatively, an electrical lead was percutaneously implanted to target the sciatic nerve for major foot/ankle surgery (e.g., hallux valgus correction), the femoral nerve for anterior cruciate ligament reconstruction, or the brachial plexus for rotator cuff repair, followed by a single injection of long-acting local anesthetic along the same nerve/plexus. Postoperatively, participants were randomized to 14 days of either electrical stimulation (n = 32) or sham stimulation (n = 34) using an external pulse generator in a double-masked fashion. The dual primary treatment effect outcome measures were (1) cumulative opioid consumption (in oral morphine equivalents) and (2) mean values of the “average” daily pain scores measured on the 0 to 10 Numeric Rating Scale within the first 7 postoperative days. Results During the first 7 postoperative days, opioid consumption in participants given active stimulation was a median (interquartile range) of 5 mg (0 to 30) versus 48 mg (25 to 90) in patients given sham treatment (ratio of geometric means, 0.20 [97.5% CI, 0.07 to 0.57]; P < 0.001). During this same period, the average pain intensity in patients given active stimulation was a mean ± SD of 1.1 ± 1.1 versus 3.1 ± 1.7 in those given sham (difference, −1.8 [97.5% CI, −2.6 to −0.9]; P < 0.001). Conclusions Percutaneous peripheral nerve stimulation reduced pain scores and opioid requirements free of systemic side effects during at least the initial week after ambulatory orthopedic surgery. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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Peripheral Nerve Blocks for the Lower Extremity

10.2310/fm.15074 ◽

2017 ◽

Author(s):

Candace Shavit ◽

Monica W. Harbell

Keyword(s):

Lower Extremity ◽

Peripheral Nerve ◽

Regional Anesthesia ◽

Nerve Block ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Improve Patient Care ◽

Nerve Blocks ◽

Peripheral Nerve Blocks ◽

Peripheral Nerve Catheter

Lower extremity peripheral nerve blocks (PNBs) are often used for surgical anesthesia and postoperative pain management. The use of PNB provides improved analgesia, reduced opioid consumption, and improved patient satisfaction and can facilitate earlier rehabilitation and discharge. As the number of lower extremity total joint arthroplasties is projected to increase significantly, the role of peripheral nerve blocks can be expected to grow in similar fashion. With the growing number of procedures and the increasing focus on patient experience and expeditious hospital discharge, PNBs are increasingly recognized as a powerful tool to improve patient care and facilitate recovery after lower extremity surgery. We provide a basic review of regional anesthesia for lower extremity surgical procedures. The widespread availability of ultrasonography has improved the performance and efficacy of PNBs; thus, we focus on ultrasonography-guided procedures. In this review, we discuss pertinent lower extremity anatomy and sonoanatomy, indications, patient outcome measures, techniques, and complications of the most commonly used blocks. This review contains 35 figures, 11 tables, 5 videos, and 103 references. Key words: adductor canal block, analgesia, ankle block, clinical applications of peripheral nerve blocks, complications of peripheral nerve blocks, continuous peripheral nerve catheter, early ambulation, fascia iliaca compartment block, femoral nerve block, lower extremity nerve blocks, lower extremity regional anesthesia, lumbar plexus block, obturator nerve block, peripheral nerve block, peripheral nerve catheter, popliteal block, psoas compartment block, regional anesthesia, regional anesthesia techniques, saphenous nerve block, sciatic nerve block, ultrasonography guided

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Acupuncture for Cancer Related Pain: Protocol for a Pragmatic Randomised Wait-List Controlled Trial

Integrative Cancer Therapies ◽

10.1177/1534735420976579 ◽

2020 ◽

Vol 19 ◽

pp. 153473542097657

Author(s):

Qi Zhao ◽

Suyang Zheng ◽

Geoff P. Delaney ◽

Eugene Moylan ◽

Meera R. Agar ◽

...

Keyword(s):

Adverse Events ◽

Rating Scale ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Post Treatment ◽

Local Health ◽

Wait List ◽

Clinical Trial Registry ◽

Numerical Rating ◽

Randomised Controlled

Background: Acupuncture has been proved effective for cancer related pain (CRP) in China, America and some other countries. However, there is relative lack of evidence to support the use of acupuncture for CRP in Australia. Objectives: To assess the effectiveness and safety of acupuncture for management of CRP in a real-world setting and to understand cancer patients’ experience of undergoing acupuncture for CRP. Methods: A pragmatic randomised controlled trial will be conducted in South Western Sydney Local Health District (SWSLHD) in NSW, Australia. Adults with cancer related pain (n = 106) will be randomised in a 1:1 ratio to receive the acupuncture intervention up front versus after a wait list period of 4 weeks. Pain level (by Numerical Rating Scale), analgesic use, auricular acupressure frequency and adverse events will be assessed at baseline, mid-treatment and post-treatment. Expectancy on trial outcome (by Credibility and Expectancy questionnaire) will be assessed at baseline. The perspective of the participants (by an interview) will be recorded after the last intervention. Expected outcomes: We hypothesise that acupuncture will relieve cancer related pain at mid-treatment and post-treatment. We also hypothesise that few adverse events will be provoked by acupuncture. Trial registration: Australia New-Zealand Clinical Trial Registry (ACTRN12620000325909).

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Femoral Nerve Blockade

Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade ◽

10.1093/med/9780199743032.003.0023 ◽

2010 ◽

pp. 347-364

Author(s):

Kimberly P. Wynd ◽

Hugh M. Smith

Keyword(s):

Side Effects ◽

Peripheral Nerve ◽

Postoperative Analgesia ◽

Ultrasound Guidance ◽

Insertion Site ◽

Femoral Nerve ◽

Needle Insertion ◽

Clinical Applications ◽

Nerve Blockade ◽

Anterior Aspect

Blockade of the femoral nerve provides surgical anesthesia and postoperative analgesia to the anterior aspect of the thigh and knee. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. A discussion of ultrasound guidance and peripheral nerve catheters completes the chapter

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