Comparison of three Different Techniques of Epidural Catheter Fixation; Conventional Loop Fixation, Catheter Tunnelling and by Fixator Device to Prevent Epidural Catheter Migration – A Prospective Randomized Control Study
Abstract
Epidural anaesthesia technique can be used to provide both anaesthesia intraoperatively and analgesia in the postoperative period. The primary objective of the study was to compare the incidence of epidural catheter inward and outward migration in conventional catheter loop tape, Catheter tunnelling and fixator device to prevent epidural Catheter migration. Secondary Objective was to compare NRS score, incidence of analgesic failure, patients comfort during epidural catheter fixation and incidence of complications in all three groups.
Materials And Methods:
156 patients posted for Lower limb Orthopaedic Elective Surgeries requiring Epidural analgesia were randomized into three groups of fifty-two in each group (Group A, Group B and Group C). Group-A had epidural catheter fixed through conventional loop tape method, Group-B had epidural catheter fixed through subcutaneous tunnelling, Group-C had epidural catheter fixed through the fixator device. Epidural catheter migration, pain score using Numerical Rating scale (NRS), incidence of analgesic failure, patients’ comfort during epidural catheter fixation and incidence of complications was assessed in all three groups.
Results:
Epidural catheter migration was significantly lesser in epidural catheter fixation devices group and tunnelling group compared to conventional loop fixation group. The incidence of analgesic failure was comparatively lesser in epidural catheter fixator devices group and subcutaneous tunnelling group when compared to conventional loop tape method. The NRS score was also significantly lower in epidural catheter fixation group and tunnelling group when compared to conventional loop fixation group. We observed higher comfort level of patients and less incidences of complications in epidural catheter fixation devices group.
Conclusion:
Epidural catheter migration was significantly reduced by subcutaneous tunnelling and epidural catheter fixation device when compared to the conventional loop tape approach in patients receiving lumbar epidural analgesia in the postoperative period. The epidural catheter fixator device is an easy, safe, and effective method which had better patient satisfaction scores and had reduced incidences of complications.
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