A pilot study to assess adductor canal catheter tip migration in a cadaver model.

Published

Journal Article

An adductor canal catheter may facilitate early ambulation after total knee arthroplasty, but there is concern over preoperative placement since intraoperative migration of catheters may occur from surgical manipulation and result in ineffective analgesia. We hypothesized that catheter type and subcutaneous tunneling may influence tip migration for preoperatively inserted adductor canal catheters. In a male unembalmed human cadaver, 20 catheter insertion trials were divided randomly into one of four groups: flexible epidural catheter either tunneled or not tunneled; or rigid stimulating catheter either tunneled or not tunneled. Intraoperative patient manipulation was simulated by five range-of-motion exercises of the knee. Distance and length measurements were performed by a blinded regional anesthesiologist. Changes in catheter tip to nerve distance (p = 0.225) and length of catheter within the adductor canal (p = 0.467) were not different between the four groups. Two of five non-tunneled stimulating catheters (40 %) were dislodged compared to 0/5 in all other groups (p = 0.187). A cadaver model may be useful for assessing migration of regional anesthesia catheters; catheter type and subcutaneous tunneling may not affect migration of adductor canal catheters based on this preliminary study. However, future studies involving a larger sample size, actual patients, and other catheter types are warranted.

Full Text

Duke Authors

Cited Authors

  • Leng, JC; Harrison, TK; Miller, B; Howard, SK; Conroy, M; Udani, A; Shum, C; Mariano, ER

Published Date

  • April 2015

Published In

Volume / Issue

  • 29 / 2

Start / End Page

  • 308 - 312

PubMed ID

  • 25288506

Pubmed Central ID

  • 25288506

Electronic International Standard Serial Number (EISSN)

  • 1438-8359

Digital Object Identifier (DOI)

  • 10.1007/s00540-014-1922-7

Language

  • eng

Conference Location

  • Japan