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Infraclavicular versus axillary nerve catheters: A retrospective comparison of early catheter failure rate
Michaela B Quast1, Hans P Sviggum1, Andrew C Hanson2
1Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, United States.
Study Objectives:
Continuous brachial plexus catheters are often used to decrease pain following elbow surgery. This investigation aimed to assess the rate of early failure of infraclavicular (IC) and axillary (AX) nerve catheters following elbow surgery.
Design:
Retrospective study.
Setting:
Postoperative recovery unit and inpatient hospital floor.
Patients:
328 patients who received IC or AX nerve catheters and underwent elbow surgery were identified by retrospective query of our institution's database.
Measurements:
Data collected included unplanned catheter dislodgement, catheter replacement rate, postoperative pain scores, and opioid administration on postoperative day 1. Catheter failure was defined as unplanned dislodging within 24 h of placement or requirement for catheter replacement and evaluated using a covariate adjusted model.
Main Results:
119 IC catheters and 209 AX catheters were evaluated. There were 8 (6.7%) failed IC catheters versus 13 (6.2%) failed AX catheters. After adjusting for age, BMI, and gender there was no difference in catheter failure rate between IC and AX nerve catheters (p = 0.449).
Conclusions:
These results suggest that IC and AX nerve catheters do not differ in the rate of early catheter failure, despite differences in anatomic location and catheter placement techniques. Both techniques provided effective postoperative analgesia with median pain scores < 3/10 for patients following elbow surgery. Reasons other than rate of early catheter failure should dictate which approach is performed.
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