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Complications of Catheter Techniques

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Complications of Regional Anesthesia

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Abstract

Catheters for prolongation of nerve blocks were first used in the 1940s, when ureteral lacquered silk catheters were applied in continuous caudal (sacral) analgesia,1,2 continuous subarachnoid block,3 and continuous lumbar epidural block.4 Thereafter, there has been a steady development in plastic material technology and polyethylene and polyvinyl catheters have been followed bypresently used nylon (polyamide), polyurethane, and Teflon (tetrafluoroethylene) catheters. Still today, there seems to be no universally ideal catheter material, and the material, design, and diameter of regional anesthesia and analgesia catheters are chosen according to the specific requirements associated with the various blocks. Overall, the catheter material is such that in a case of resistance or obstruction, the catheter must not break.5 For example, an epidural catheter should advance into and through the needle rather than flex excessively when resistance is encountered, and yet still bend and deflect off tissue.6 The deflection property has been solved in some of the epidural catheters by a “soft” and flexible steel coil extension of the tip (e.g., Arrow Flextip®). An intrathecal catheter should be soft, relatively thin, and resistant to kinking. However, a brachial plexus catheter has to be relatively stiff and blunt. In addition to acceptable tissue compatibility, the catheter must also withstand the destructive (solubilizing) action of the neurolytic drug solutions administered through the catheters, such as 6%–10% phenol or 100% ethanol.

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  1. Department of Anesthesiology and Intensive Care Medicine, Helsinki University, Helsinki, Finland

    Per H. Rosenberg MD, PhD (Professor of Anesthesiology)

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  1. Per H. Rosenberg MD, PhD
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  1. Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada

    Brendan T. Finucane MB, BCh, BAO, FRCA, FRCPC (Professor) (Professor)

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Rosenberg, P.H. (2007). Complications of Catheter Techniques. In: Finucane, B.T. (eds) Complications of Regional Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68904-3_15

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