Eficacia comparativa de los apósitos quirúrgicos Micropore™, Tegaderm™ y Lockit plus® para la fijación del catéter epidural lumbar en niños: ensayo controlado aleatorizado de grupo paralelo prospectivo / Comparative efficacy of MicroporeTM surgical dressing, TegadermTM and Lockit plus® for lumbar epidural catheter fixation in children: a prospective parallel group randomized controlled trial

Antecedentes: La fijación adecuada del catéter epidural es necesaria para evitar su desplazamiento y lograr el efecto deseado del fármaco. Se han utilizado diferentes técnicas para la fijación del catéter epidural. El objetivo del estudio fue comparar la eficacia relativa de los apósitos quirúrgicos Micropore™, Tegaderm™ y Lockit plus® en la prevención de la migración del catéter epidural lumbar en niños. Métodos Se estudiaron 167 pacientes de 5 a 16 años, hasta un periodo de 48h después de la cirugía electiva abdominal o de miembros inferiores. Los pacientes fueron asignados aleatoriamente a uno de tres grupos: 1) apósito quirúrgico Micropore™ (grupo M); 2) Tegaderm™ (grupo T), o 3) Lockit plus® (grupo L). Se compararon la incidencia y la extensión de la migración del catéter epidural en centímetros (cm) transcurridas 24 y 48 horas de la fijación epidural. También se analizó la correlación entre la migración del catéter epidural y las características de los pacientes, así como la incidencia relativa de complicaciones en los tres grupos. Resultados La incidencia media de migración del catéter fue de 9,6% a las 24 horas (grupo M: 7,1%; grupo T: 21,1%; grupo L: 0%) y del 45,5% a las 48 horas (grupo M: 66,1%; grupo T: 45,6%; grupo L: 24,1%). Después de 48 horas, la migración absoluta (migración media redondeada al valor más cercano a 0,5cm) fue menor en los pacientes del grupo L: 0,34cm (1,39) en comparación con el grupo M: 1,22cm (SD: 1,85) y el grupo T: 0,94cm (1,94) (p=<0,001). Conclusión Hasta 48 horas después de la cirugía, el dispositivo Lockit plus® demostró una menor migración del catéter epidural en comparación con el apósito quirúrgico Micropore™ o Tegaderm™ en niños sometidos a cirugía electiva abdominal o de extremidades inferiores. (AU)

Background: Proper fixation of an epidural catheter is necessary for desired drug effect and to prevent catheter displacement. Different techniques have been used for epidural catheter fixation. The aim of the study was to compare the relative efficacy of Micropore™ surgical dressing, Tegaderm™, and Lockit plus® in preventing lumbar epidural catheter migration in children. Methods We studied 167 patients aged 5-16 years, for up to 48hrs. after the elective abdominal or lower limb surgery. Patients were randomly assigned to one of three groups: 1) Micropore™ surgical dressing (group M), 2) Tegaderm™ (group T), or 3) Lockit plus® (group L). Incidence and extent of epidural catheter migration in centimetres (cm); was compared at 24 and 48hours post epidural fixation. Correlation between epidural catheter migration and patient characteristics, and relative incidence of complications in three groups was also analysed. Results Incidence of catheter migration was 9.6% at 24hours (group M: 7.1%, group T: 21.1% and group L: 0%) and 45.5% at 48hours (group M: 66.1%, group T: 45.6% and group L: 24.1%). After 48hours, absolute migration (mean migration rounded off to the nearest 0.5cm) was least in patients in group L: 0.34cm (1.39) compared to group M 1.22cm (SD: 1.85) group T: 0.94cm (1.94) (p = <0.001). Conclusion Up to 48 hours after surgery, the Lockit plus® device demonstrated the less epidural catheter migration when compared to micropore surgical dressing or tegaderm in children undergoing elective abdominal or lower limb surgery. (AU)

Comparative efficacy of Micropore™ surgical dressing, Tegaderm™ and Lockit plus® for lumbar epidural catheter fixation in children: a prospective parallel group randomized controlled trial.

BACKGROUND: Proper fixation of an epidural catheter is necessary for desired drug effect and to prevent catheter displacement. Different techniques have been used for epidural catheter fixation. The aim of the study was to compare the relative efficacy of Micropore™ surgical dressing, Tegaderm™, and Lockit plus® in preventing lumbar epidural catheter migration in children. METHODS: We studied 167 patients aged 5-16 years, for up to 48 h. After the elective abdominal or lower limb surgery. Patients were randomly assigned to one of three groups: (1) Micropore™ surgical dressing (group M), (2) Tegaderm™ (group T), or (3) Lockit plus® (group L). Incidence and extent of epidural catheter migration in centimetres (cm); was compared at 24 and 48 h post epidural fixation. Correlation between epidural catheter migration and patient characteristics, and relative incidence of complications in three groups was also analysed. RESULTS: Incidence of catheter migration was 9.6% at 24 h (group M: 7.1%, group T: 21.1% and group L: 0%) and 45.5% at 48 h (group M: 66.1%, group T: 45.6% and group L: 24.1%). After 48 h, absolute migration (mean migration rounded off to the nearest 0.5 cm) was least in patients in group L: 0.34 cm (1.39) compared to group M 1.22 cm (SD: 1.85) group T: 0.94 cm (1.94) (p = <0.001). CONCLUSION: Up to 48 h after surgery, the Lockit plus® device demonstrated the less epidural catheter migration when compared to micropore surgical dressing or tegaderm in children undergoing elective abdominal or lower limb surgery.