To Remove or Not to Remove a Broken Perineural Catheter Fragment?

Vol 4 | Issue 1 | January-June 2023 | Page 26-28 | Trupti Pethkar, Harshal Wagh

DOI: https://doi.org/10.13107/ijra.2023.v04i01.071


Authors: Trupti Pethkar [1], Harshal Wagh [1]

[1] Department of Anaesthesia, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Trupti Pethkar,
Department of Anaesthesia, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India.
E-mail: truptipethkar@yahoo.co.in


Fracture of femoral perineural catheter during insertion is the extremely rare complication of an otherwise low risk procedure. In such a scenario, whether to leave the catheter in situ or extract it by surgical exploration is the dilemma. We present two cases of broken femoral perineural catheter incurred during insertion. Since patients do not complain of any kind of immediate pain or discomfort, after shearing of the catheter, the decision making regarding the further management is difficult. But, there are incidences of long term complication like femoral neuritis leading to constant dragging pain. This makes us uncomfortable and force to think whether these broken fragments should left in situ.
Keywords: Femoral perineural catheter, Femoral nerve block, Fractured catheter fragment


References


[1] Joshi G, Gandhi K, Shah N, Gadsden J, Corman SL. Peripheral nerve blocks in the management of postoperative pain: challenges and opportunities. Journal of Clinical Anesthesia 2016;35:524-9.
[2] Aveline C, Le Hetet H , Le Roux A, Vautier P, Gautier JF, Cognet F. Perineural ultrasound-guided catheter bacterial colonization: a prospective evaluation in 747 cases. Reg Anesth Pain Med 2011;36:579-84.
[3] Ilfeld BM. Continuous peripheral nerve blocks: a review of the published evidence. Anesth Analg 2011;113:904-25.
[4] Adam F, Jaziri S, Chauvin M. Psoas Abscess Complicating Femoral Nerve Block Catheter. Anesthesiology 2003;99:230–1.
[5] Sharma S, Iorio R, Specht LM, Davies-Lepie S, Healy WL. Complications of femoral nerve block for total knee arthroplasty. Clin Orthop Relat Res 2010;468(1):135-40.
[6] Lee BH and Goucke CR. Shearing of a Peripheral Nerve Catheter. Anesthesia & Analgesia 2002;95(3):760-1.
[7] Guerci P, Novy E, Guibert J, Vial F, Malinovsky JM, Bouaziz H. Cisaillements accidentels de cathéters périnerveux lors de poses échoguidées [Inadvertent peripheral nerve catheter shearing occurring during ultrasound guidance]. Ann Fr Anesth Reanim. 2013;32(5):364-7(in French).
[8] Khabiri B, Hamilton C, Norton J, Arbona F, Carlson L. The Difficulty to Remove Perineural Catheter: A Technique for Removing an Intact Catheter. Open Journal of Anesthesiology 2013;3(6):304-7.


How to Cite this Article: Pethkar T, Wagh H | To Remove or Not to Remove a Broken Perineural Catheter Fragment? | International Journal of Regional Anaesthesia | January-June 2023; 4(1): 26-28 | DOI: https://doi.org/10.13107/ijra.2023.v04i01.071


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