Паёми Сино (Dec 2024)
OPTIMAL CATHETER SECUREMENT FOR EXTENDED BRACHIAL PLEXUS BLOCKADE
Abstract
Objective: To develop and implement an effective method of placing and maintaining perineural catheters during an extended brachial plexus block (BPB) via a supraclavicular approach. This method was based on patient and medical personnel feedback and focused on comfort, efficiency, and convenience. Methods: : The research involved patients who had undergone surgery for fractures of the humerus and forearm bones and had received extended BPB via the supraclavicular approach. The patients were categorized into three groups based on the method of catheter fixation. The first group consisted of patients with catheter fixation in the supraclavicular region using an adhesive patch (n=31), the second group had catheter fixation using a Perifix® (B. Braun Melsungen AG, Germany), a catheter securement device (n=33), and the third group had the catheter fixed with a subcutaneous tunnel and loop (n=34). The study aimed to determine the most comfortable, effective, and convenient method of catheter fixation for extended BPB. Two questionnaires were used to assess this, one for the patients and the other for medical personnel. The scores from both questionnaires were combined, and a comparative analysis of the three fixation methods was conducted. Results: In the first group of patients, the level of comfort, efficiency, and convenience was evaluated as unsatisfactory (7.0 [7.0; 10.0]); in the second group, the assessment was deemed satisfactory (12.0 [11.0; 13.0]). However, in the third group of patients, the level of comfort, efficiency, and convenience was rated as optimal (16.0 [15.0; 17.0], p<0.001). Conclusion: According to the study results, the most comfortable, effective, and convenient catheter fixation method for extended BPB via supraclavicular approach involved a subcutaneous tunnel and loop in the subclavian region.
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