Risk of catheter-associated infection in young hematology/ oncology patients receiving long-term peripheral nerve blocks

Doralina L. Anghelescu, Brittney L. Harris, Lane G. Faughnan, Linda L. Oakes, Kelley B. Windsor, Becky B. Wright, Jonathan Mccullers

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheterassociated infection with prolonged CPNBs has not been previously investigated. Aim: We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage. Methods: All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records. Results: The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively. Conclusion: Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥10 days) use.

Original languageEnglish (US)
Pages (from-to)1110-1116
Number of pages7
JournalPaediatric Anaesthesia
Volume22
Issue number11
DOIs
StatePublished - Nov 1 2012
Externally publishedYes

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Catheter-Related Infections
Nerve Block
Hematology
Peripheral Nerves
Catheters
Infection
Critical Care
Thigh
Anti-Bacterial Agents
Postoperative Pain
Chronic Pain
Medical Records
Orthopedics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

Cite this

Risk of catheter-associated infection in young hematology/ oncology patients receiving long-term peripheral nerve blocks. / Anghelescu, Doralina L.; Harris, Brittney L.; Faughnan, Lane G.; Oakes, Linda L.; Windsor, Kelley B.; Wright, Becky B.; Mccullers, Jonathan.

In: Paediatric Anaesthesia, Vol. 22, No. 11, 01.11.2012, p. 1110-1116.

Research output: Contribution to journalArticle

Anghelescu, Doralina L. ; Harris, Brittney L. ; Faughnan, Lane G. ; Oakes, Linda L. ; Windsor, Kelley B. ; Wright, Becky B. ; Mccullers, Jonathan. / Risk of catheter-associated infection in young hematology/ oncology patients receiving long-term peripheral nerve blocks. In: Paediatric Anaesthesia. 2012 ; Vol. 22, No. 11. pp. 1110-1116.
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AU - Oakes, Linda L.

AU - Windsor, Kelley B.

AU - Wright, Becky B.

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N2 - Background: Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheterassociated infection with prolonged CPNBs has not been previously investigated. Aim: We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage. Methods: All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records. Results: The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively. Conclusion: Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥10 days) use.

AB - Background: Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheterassociated infection with prolonged CPNBs has not been previously investigated. Aim: We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage. Methods: All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records. Results: The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively. Conclusion: Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥10 days) use.

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