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Effective epidural catheter fixation is a key aspect of postoperative pain management in pediatric patients. We conducted a prospective, randomized study comparing the efficacy and safety of adhesive strip (Steri-StripsTM) vs subcutaneous tunneling for successful epidural catheter fixation. Materials and methods: American Society of Anesthesiologists (ASA) grades I and II patients between the age group of 1 day and 12 years were included in the study. The parameters studied were inward and outward migration, and dislodgment of catheter. Erythema, induration, catheter snapping, catheter obstruction, total duration of epidural infusion, and catheter tip culture were also recorded. Feedback from the operator for ease of fixation technique was noted and reviewed. Results: This study was performed in 64 patients posted for various abdominal, thoracic, and genital surgeries, requiring postoperative epidural analgesia. The epidural catheter was successfully placed in the first attempt in 61 patients. Outward migration was seen in six patients with Steri-Strips-taped catheters and in one patient with a tunneled catheter. Accidental removal was done in five patients with tunneled catheters and one patient with strip-taped catheter. Rescue analgesics were required in these patients. No inward migration of catheter was seen in both the groups. Bleeding from tunneling site was seen in five patients. Conclusion: In comparison with a tunneling technique for epidural catheter fixation, a simple method of applying SteriStripsTM to epidural catheters significantly reduces the incidence of accidental removal.

research and innovation in anesthesia

A Prospective, Randomized Study comparing the Efficacy and Safety of Adhesive Strip (Steri-Strips™) Fixation vs Subcutaneous Tunneling for securing Epidural Catheters in Pediatric Patients