Abstract
We investigated the efficacy of a new technique of epidural catheter fixation that relies on a strip of adhesive foam transfixed by a securing suture. We compared this technique to a tunnelled technique in a prospective, randomized trial (n=25 in each group). Epidural catheter depth was recorded at the time of insertion and at the time of removal. Clinically significant catheter movement was considered as >2 cm outward movement or >1 cm inward movement. The mean duration of epidural analgesia was five days for both groups. Clinically significant movement was noted in eight patients (32%) in the tunnelled group and seven patients (28%) in the sutured group (P=0.75). Movement of the epidural catheter did not correlate with analgesic failure. The sutured technique provided similar protection against migration to tunnelling but any potential advantages were offset by concerns about a significantly higher incidence of erythema around the catheter exit site in the sutured group (1 vs 6 patients, P=0.04).