Method for Assessing the Degree of External Dislocation of the Catheter for Prolonged Brachial Plexus Block

AIM OF STUDY To demonstrate the effectiveness and safety of a method for assessing the degree of external dislocation of a catheter for continuous brachial plexus block (CBPB) using a dislocation scale in clinical practice. MATERIAL AND METHODS The study included 63 patients who underwent CBPB from the supraclavicular approach with fixation of the catheter on the skin with a patch sticker during operations for fractures of the bones of the upper limb. To analyze the size of the catheter dislocation, a method for assessing the degree of external dislocation of the catheter for CBPB was used. RESULTS In 16 patients, the size of the external dislocation was from 0 mm to 5 mm (grade 1), which was assessed as no dislocation, in 30 patients it was more than 5 mm to 10 mm (grade 2), while there were no changes in the quality of pain relief, in 15 patients the dislocation was more than 10 mm to 15 mm (grade 3), while there was a deterioration in the quality of pain relief, it was necessary to increase the dose of the administered local anesthetic and strengthen the fixation of the catheter to the skin of the supraclavicular region with a fixation device, in 2 patients the size of the external dislocation was more than 15 mm (grade 4), which was defined as migration of the catheter beyond the brachial plexus and led to the cessation of CPBP. CONCLUSION The physician operating the catheter for prolonged brachial plexus block, using the method of assessing the degree of external dislocation, has the opportunity to determine the likelihood of deterioration in the quality of anesthesia based on the size of the dislocation and prevent its cessation.