Tunneling and Suture of Thoracic Epidural Catheters Decrease the Incidence of Catheter Dislodgement
Table 2
Data concerning contaminated epidural catheters.
Age
Sex
Site
Level
Duration (h)
Dislocation
Pathogen
Comorbidities
Perioperative antibiotics
Punctures
Signs of infection
MG
DM
CS
CT
Group 1 (tunneled)
47
M
Paramedian
Mid
147
CoNS*
Yes
No
No
Yes
CPZ (2 g)
1 x
Ø
61
M
Midline
High
294
CoNS*
Yes
No
No
No
CPZ (2 g) + METRO** (0.5 g)
2 x (os)
Ø
62
F
Midline
Mid
99
CoNS*
Yes
No
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
76
F
Midline
Mid
100
CoNS*
Yes
No
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
79
F
Midline
Mid
74
10 mm out
CoNS*
Yes
No
No
Yes
CPZ (2 g) + METRO** (0.5 g)
2 x (os)
Ø
44
M
Midline
Low
48
CoNS*
No
No
No
No
CPZ (2 g)
1 x
Ø
36
M
Midline
Low
124
CoNS*
Yes
No
No
No
CFTX (2 g)
1 x
Ø
61
M
Midline
High
101
STAEPI
Yes
No
No
No
CPZ (2 g)
1 x
Ø
Group 2 (taped)
55
M
Midline
Mid
76
CoNS*
Yes
No
No
No
CPZ (2 g)
1 x
Ø
68
M
Paramedian
Mid
124
CoNS*
Yes
No
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
78
F
Midline
Mid
93
30 mm in
CoNS*
Yes
Yes
No
No
CPZ (2 g) + METRO** (0.5 g)
2 x
Ø
66
M
Midline
Mid
96
CoNS*
Yes
No
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
53
M
Midline
Mid
194
CoNS*
Yes
No
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
75
F
Midline
Mid
76
10 mm out
CoNS*
Yes
Yes
No
No
CPZ (2 g)
1 x
Ø
71
M
Midline
Low
70
CoNS*
Yes
No
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
53
M
Midline
High
99
20 mm out
STAAUR
Yes
No
No
Yes
CPZ (2 g) + METRO** (0.5 g)
1 x
Redness, swelling
76
M
Midline
Mid
190
CoNS*
Yes
Yes
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
83
F
Paramedian
Low
148
CoNS*
Yes
No
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
66
F
Midline
Low
100
CoNS*
Yes
No
Yes
No
CFTX (2 g)
1 x
Ø
61
M
Paramedian
High
96
90 mm out
CoNS* + ENCFIS
Yes
No
No
No
CPZ (2 g)
1 x
Ø
37
M
Midline
Mid
167
CoNS*
No
No
No
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
53
M
Midline
Mid
95
20 mm in
CoNS*
No
No
Yes
No
CPZ (2 g) + METRO** (0.5 g)
1 x
Ø
=
0.2
0.5
0.9
0.4
0.4
MG: malignancy; DM: diabetes mellitus; CS: corticosteroids; CT: chemotherapy; *CoNS: coagulase-neg. staphylococci; STAEPI: Staphylococcus epidermidis; STAAUR: Staphylococcus aureus; ENCFIS: Enterococcus faecalis; CPZ: cephazoline; **METRO: metronidazole; CFTX: ceftriaxone; antibiotics were administered exclusively in the perioperative period. Note that none of the contaminated epidural catheters in the tunneled and only one epidural catheter the taped group showed clinical signs of infection. Student’s -test, Fisher’s exact test, and Mann-Whitney test were used for statistical testing. Of note, the patient of the taped group with a 90 mm catheter dislodgment showed no signs of insufficient analgesia during rest; however, his visual analogue scale was 5-6 on movement for the first three days.
