Prolonged Catheter Use and Infection in Regional Anesthesia: A Retrospective Registry Analysis

被引：66

作者：

Bomberg, Hagen ^{[1
]}

Bayer, Ina ^{[1
]}

Wagenpfeil, Stefan ^{[2
]}

Kessler, Paul ^{[3
]}

Wulf, Hinnerk ^{[4
]}

Standl, Thomas ^{[5
]}

Gottschalk, Andre ^{[6
]}

Doeffert, Jens ^{[7
]}

Hering, Werner ^{[8
]}

Birnbaum, Juergen ^{[9
,10
]}

Spies, Claudia ^{[9
,10
]}

Kutter, Bernd ^{[11
]}

Winckelmann, Joerg ^{[11
]}

Liebl-Biereige, Simone ^{[12
]}

Meissner, Winfried ^{[13
]}

Vicent, Oliver ^{[14
]}

Koch, Thea ^{[14
]}

Sessler, Daniel I. ^{[15
]}

Volk, Thomas ^{[1
]}

Raddatz, Alexander ^{[1
]}

机构：

[1] Saarland Univ, Univ Med Ctr, Dept Anesthesiol Intens Care Med & Pain Med, Homburg, Germany

[2] Saarland Univ, Univ Med Ctr, Inst Med Biometry Epidemiol & Med Informat, Homburg, Germany

[3] Orthoped Univ Hosp, Dept Anesthesiol Intens Care & Pain Med, Frankfurt, Germany

[4] Philipps Univ Marburg, Dept Anesthesiol & Intens Care Therapy, Marburg, Germany

[5] Acad Hosp Solingen, Dept Anesthesia Intens & Palliat Care Med, Solingen, Germany

[6] Friederikenstift Hannover, Dept Anesthesiol Intens Care & Pain Med, Hannover, Germany

[7] Hosp Calw Nagold, Dept Anesthesiol & Intens Care Med, Nagold, Germany

[8] St Marien Hosp, Dept Anesthesiol, Siegen, Germany

[9] Charite, Dept Anesthesiol & Operat Intens Care Med, Charite Campus Virchow Klinikum, Berlin, Germany

[10] Charite, Campus Mitte, Berlin, Germany

[11] Univ & Rehabil Clin, Dept Anesthesiol Intens Care & Pain Therapy, Ulm, Germany

[12] HELIOS Hosp Erfurt, Dept Anesthesiol Intens Care & Pain Therapy, Erfurt, Germany

[13] Jena Univ Hosp, Dept Anesthesiol & Intens Care, Jena, Germany

[14] Tech Univ Dresden, Dept Anesthesiol, Intens Care Med, Univ Hosp Carl Gustav Carus, Dresden, Germany

[15] Cleveland Clin, Dept Outcomes Res, Inst Anesthesiol, Cleveland, OH 44106 USA

来源：

ANESTHESIOLOGY | 2018年 / 128卷 / 04期

关键词：

PERIPHERAL-NERVE BLOCKS; EPIDURAL CATHETERS; RISK-FACTOR; COMPLICATIONS; MANAGEMENT; ANALGESIA; SURGERY; OBESITY;

D O I：

10.1097/ALN.0000000000002105

中图分类号：

R614 [麻醉学];

学科分类号：

100217 [麻醉学];

摘要：

Background: Prolonged catheter use is controversial because of the risk of catheter-related infection, but the extent to which the risk increases over time remains unknown. We thus assessed the time-dependence of catheter-related infection risk up to 15 days. Methods: Our analysis was based on the German Network for Regional Anesthesia, which includes 25 centers. We considered 44,555 patients who had surgery between 2007 and 2014 and had continuous regional anesthesia as well as complete covariable details. Cox regression analysis was performed and adjusted for confounding covariables to examine the relationship between catheter duration and probability of infection-free catheter use. Results: After adjustment for confounding factors, the probability of infection-free catheter use decreases with each day of peripheral and epidural catheter use. In peripheral catheters, it was 99% at day 4 of catheter duration, 96% at day 7, and 73% at day 15. In epidural catheters, it was 99% at day 4 of catheter duration, 95% at day 7, and 73% at day 15. Only 31 patients (0.07%) had severe infections that prompted surgical intervention. Among these were five catheters that initially had only mild or moderate signs of infection and were left in situ; all progressed to severe infections. Conclusions: Infection risk in catheter use increases over time, especially after four days. Infected catheters should be removed as soon as practical. Visual Abstract: An online visual overview is available for this article at http://links.lww.com/ALN/B683.

引用

页码：764 / 773

页数：10

共 36 条

[1]

Efficacy of postoperative epidural analgesia - A meta-analysis [J].