Peripheral nerve catheters in children: An analysis of safety and practice patterns from the pediatric regional anesthesia network (PRAN)

B. J. Walker, J. B. Long, G. S. De Oliveira, P. Szmuk, C. Setiawan, D. M. Polaner, S. Suresh

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Background Peripheral nerve catheters (PNCs) are used with increasing frequency in children. Although adult studies have demonstrated safety with this technique, there have been few safety studies in children. The main objective of the current investigation was to examine the incidence of PNC complications in children undergoing surgery. Methods This is an observational, multi-institutional study using the Pediatric Regional Anesthesia Network (PRAN) database. Data pertaining to PNCs were entered prospectively into a secure, online database by each participating centre. Patient characteristics, anatomic location, localization techniques, medications used, and complications were recorded for each catheter. All complications and any sequelae were followed until resolution. Results There were 2074 PNCs included in the study. 251 adverse events and complications were recorded, resulting in an overall incidence (95% CI) of complications of 12.1% (10.7-13.5%). The most common complications were catheter malfunction, block failure, infection, and vascular puncture. There were no reports of persistent neurologic problems, serious infection, or local anaesthetic systemic toxicity, resulting in an estimated incidence (95% CI) of 0.04% (0.001-0.2%). Patients who developed an infection had used the catheters for a greater number of days, median (IQR) of 4.5 (3-7) days compared with 3 (1-3) days in the patients who did not develop an infection, P<0.0001. Conclusions Our data support the safety of placing PNCs in children, with adverse event rates similar to adult studies. Catheter problems are common, yet minor, in severity.

Original languageEnglish (US)
Pages (from-to)457-462
Number of pages6
JournalBritish Journal of Anaesthesia
Volume115
Issue number3
DOIs
StatePublished - Sep 1 2015

Keywords

  • analgesia
  • catheter
  • children
  • complication
  • nerve
  • paediatrics
  • pain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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