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Inflammation and infection complications of 2285 perineural catheters: a prospective study

Authors

  • M. Neuburger,

    1. 1Department of Anesthesiology, Berufsgenossenschaftliche Unfallklinik Murnau, Germany and 2Department of Anesthesiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland
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  • 1 J. Büttner,

    1. 1Department of Anesthesiology, Berufsgenossenschaftliche Unfallklinik Murnau, Germany and 2Department of Anesthesiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland
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  • 1 S. Blumenthal,

    1. 1Department of Anesthesiology, Berufsgenossenschaftliche Unfallklinik Murnau, Germany and 2Department of Anesthesiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland
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  • 2 J. Breitbarth,

    1. 1Department of Anesthesiology, Berufsgenossenschaftliche Unfallklinik Murnau, Germany and 2Department of Anesthesiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland
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  • and 1 A. Borgeat 2

    Corresponding author
    1. 1Department of Anesthesiology, Berufsgenossenschaftliche Unfallklinik Murnau, Germany and 2Department of Anesthesiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland
      Professor Alain Borgeat
      Department of Anesthesiology
      Orthopedic University Hospital Balgrist
      Forchstrasse 340
      CH-8008 Zurich
      Switzerland
      e-mail: alain.borgeat@balgrist.ch
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Professor Alain Borgeat
Department of Anesthesiology
Orthopedic University Hospital Balgrist
Forchstrasse 340
CH-8008 Zurich
Switzerland
e-mail: alain.borgeat@balgrist.ch

Abstract

Background:  Perineural catheters (PNCs) are increasingly being used. Few data are available on the infectious complications of PNCs. The incidence and localization of local inflammation and infection associated with PNCs were assessed.

Methods:  PNCs placed under sterile conditions for regional anesthesia and post-operative analgesia were evaluated prospectively. Local inflammation was defined as redness, swelling or pain on pressure at the catheter insertion site. Infection was defined as purulent material at the catheter insertion site with or without the need for surgical intervention.

Results:  In total, 2285 PNCs were evaluated: 600 axillary, 303 interscalene, 92 infraclavicular, 65 psoas compartment, 574 femoral, 296 sciatic and 355 popliteal. Local inflammation occurred in 4.2% and infection in 3.2%. The duration of PNC placement was a risk factor (P < 0.05). Surgical intervention was necessary in 0.9%. No late complications occurred in any patient. Interscalene catheters were associated with an increased risk of infection (4.3%; P < 0.05). Anterior proximal sciatic catheters were associated with a lower risk of local inflammation (1.7%; P < 0.05) and infection (0.4%; P < 0.05). Staphylococcus epidermidis and Staphylococcus aureus were isolated in 42% and 58% of catheter tip cultures, respectively.

Conclusion:  In the present study population, infection of PNCs was a rare occurrence, but the incidence increased with the duration of PNC placement, and close clinical monitoring is required.

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