Assessment and Comparison of The Slippage and Unintentional Opening of Epidural Catheters and Their Connectors
Anesthesia & Pain Research
The unintended disconnection of epidural catheters from their connector may result in inadequate analgesia and increase risk of infection, among others. In order to provide quality improvement, all factors associated with such disconnections must be evaluated, including both operator expertise and manufacturer flaws. This study was created to evaluate the latter in hopes of providing objective data as to which brand of catheters are more prone to detach from the epidural catheter. Methods :
... eter. Methods : This study compared both the force needed to dislodge (unintended disengagement) the connector from the catheter, and to cause the connector to open (unintended opening). We evaluated three brands of catheters: B-Braun Perifix, Smith Portex, and the Arrow. To assess the aforementioned forces we utilized the Applied Test System (ATS) tensile test apparatus and fixed the catheters to the machinery and exerted a quantitative force until the catheter either slipped or the connecter was forced open. In addition, we evaluate the efficacy of the proposed use of a piece of adhesive to prevent unintentional catheter disconnection. Each catheter type was tested 10 times to assess for variability. Results: The amount of force needed to cause the unintentional disconnection for the B. Braun Perifix, Smith Portex Epifuse and Arrow catheters was 8.127 Newtons, 8.310 Newtons, and 4.183 Newtons, respectively. The p-values comparing the B. Braun to Smith (p=0.432), B. Braun to Arrow (p<0.0001), and Smith to Arrow (p<0.0001). The amount of force needed to cause the catheter connector to open for the B. Braun Perifix, Smith Portex Epifuse and Arrow catheters was 29.251 Newtons, 32.518 Newtons, and 4.403 Newtons, respectively. The p-values comparing the connector opening of B. Braun to Smith (p=0.0021), B. Braun to Arrow (p<0.0001), and Smith to Arrow (p<0.0001). Conclusions: When comparing all three catheter types, the mechanical integrity of the Arrow appears be inferior to both the B. Braun and Smith Portex catheter for both disconnection and connector opening. No significant difference was noted between B. Braun and the Smith catheters when assessing catheter-connector disconnection. The Smith Portex catheter proved to be the strongest catheter when assessing connector opening forces. The B-Braun and the Smith catheter benefited from the use of adhesive when assessing opening forces, whereas the B-Braun showed no benefit when gaging disconnection forces. The use of the Snaplock TM adaptor is highly recommended when using the Arrow catheter.