Dislodgment of continuous suprascapular nerve block catheters after physiotherapy: A cadaver study

P. Goffin , L. Morales , E. Jorcano , A. Prats-Galino , M.A. Reina , X. Sala-Blanch
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Abstract

Background

Continuous peripheral nerve blocks are commonly used for pain management. However, the incidence of catheter dislodgement or migration is unclear, and may be underestimated and underreported. Our objective was to assess suprascapular catheter tip positioning before and after routine simulated shoulder physiotherapy manipulation in an anatomical cadaver model.

Method

Eight ultrasound-guided continuous suprascapular nerve block catheters were placed in cryopreserved fresh cadavers. Computed tomography (CT) confirmed the location of the catheter tip after injection of 1 ml of contrast medium. We performed a series of standardized shoulder movements during a simulated shoulder physiotherapy session in cadavers. Following this, we administered 1 ml of methylene blue through the catheters, and then performed anatomical dissections to accurately identify the location of the catheter tips and compare them to their placement prior to the 'physiotherapy'.

Result

CT imaging confirmed the location of the catheter tips at the suprascapular notch in all cases. However, following physiotherapy, 2 catheters (25%) were found to have migrated - specifically, 1 was located in the supraspinatus muscle, and the other was located in the trapezius muscle.

Conclusion

Our findings suggest that catheter dislodgement may occur in approximately 25% of cases following simulated physiotherapy manipulation. However, further research is needed to determine the read incidence of catheter dislodgement in clinical practice.

物理治疗后连续性肩胛上神经阻滞导管的脱落:尸体研究。
背景:连续性周围神经阻滞常用于疼痛治疗。然而,导管脱落或移位的发生率尚不清楚,可能被低估或漏报。我们的目的是在解剖尸体模型中评估肩胛上导管尖端在常规模拟肩部理疗操作前后的定位情况:方法:在冷冻保存的新鲜尸体中置入 8 根超声引导的连续肩胛上神经阻滞导管。注射 1 毫升造影剂后,计算机断层扫描(CT)确认了导管尖端的位置。在尸体的模拟肩部理疗过程中,我们进行了一系列标准化肩部运动。之后,我们通过导管注入 1 毫升亚甲蓝,然后进行解剖,以准确确定导管尖端的位置,并将其与 "理疗 "前的位置进行比较。 结果:CT 成像证实所有病例的导管尖端都位于肩胛上凹陷处。然而,在物理治疗后,发现有 2 根导管(25%)发生了移位,其中 1 根位于冈上肌,另 1 根位于斜方肌:我们的研究结果表明,约有 25% 的病例可能会在模拟物理治疗操作后发生导管移位。然而,要确定临床实践中导管脱落的发生率,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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