Analgesic Pump Tubing Securement to Prevent Dislodgement of Peripheral Vein Indwelling Catheter

Abstract

Purpose: This study aims to compare the incidence of complications when using a new approach to secure an indwelling peripheral venous catheter (PVC), involving tying of the tube with a surgical knot at two places and several layers of elastic adhesive bandage, with a standard approach using sterile, transparent, and protective film.

Methods: This study enrolled 311 consecutive adults undergoing thoracoscopic lobectomy under general anesthesia at Taizhou Hospital of Zhejiang Province between October 2017 and May 2018. Patients were randomized to experimental and control groups and were followed for up to 72 hours. The primary endpoint was dislodgement of the PVC. Secondary endpoints were blood in the catheter; analgesia pump obstruction alarm; time taken and cost of PVC replacement; replacement of securing materials and analgesia pump line; and time and cost of replacing them. All adverse events were recorded.

Findings: Final analysis included 248 patients (experimental group: n = 126; control group: n = 122). PVC dislodgement was less frequent in the experimental group than in the control group. In the control group, 78.7% of patients required replacement of securing materials (costing 37 cents each time) and 13.1% required PVC replacement (costing 3.6 dollars each time), necessitating additional nursing time. No patients in the experimental group required replacement of the PVC or securing materials. Blisters were less common in the experimental group than in the control group (0% vs 9.84%, P < .001). No patients had limb edema.

Conclusions: This new method of securing an analgesia pump line can reduce traction on the indwelling PVC, lowering the dislodgement rate.

Keywords: analgesia pump; complications; fixation method; peripheral vein indwelling catheter.