A comparison of strength for two continuous peripheral nerve block catheter dressings

BACKGROUND Despite the benefits of continuous peripheral nerve blocks, catheter dislodgment remains a major problem, especially in the ambulatory setting. However, catheter dressing techniques to prevent such dislodgment have not been studied rigorously. We designed this simulation study to test the strength of two commercially available catheter dressings. METHODS Using a cadaver model, we randomly assigned 20 trials to one of two dressing techniques applied to the lateral thigh: 1) clear adhesive dressing alone, or 2) clear adhesive dressing with an anchoring device. Using a digital luggage scale attached to a loop secured by the dressing, the same investigator applied steadily increasing force with a downward trajectory towards the floor until the dressing was removed or otherwise disrupted. RESULTS The weight, measured (median [10th-90th percentile]) at the time of dressing disruption or removal, was 1.5 kg (1.3-1.8 kg) with no anchoring device versus 4.9 kg (3.7-6.5 kg) when the dressing included an anchoring device (P < 0.001). CONCLUSIONS Based on this simulation study, using an anchoring device may help prevent perineural catheter dislodgement and therefore premature disruption of continuous nerve block analgesia.