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Conventional Catheters (conventional + catheter)

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Selected Abstracts

Stimulating or conventional perineural catheters after hallux valgus repair: a double-blind, pharmaco-economic evaluation

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2006
A. Casati
Background:, We prospectively evaluated direct analgesia-related costs of continuous sciatic nerve block using either a stimulating or conventional catheter after hallux valgus repair. Methods:, The perineural catheter was inserted through a stimulating introducer either blindly (group Conventional, n= 38) or while stimulating via the catheter (group Stimulating, n= 38). Nerve block was induced with 25 ml of mepivacaine 15 mg/ml, and was followed 3 h later by a patient-controlled infusion of ropivacaine 2 mg/ml (basal infusion: 3 ml/h; incremental dose: 5 ml; lock-out time: 30 min). Rescue tramadol [100 mg intravenous (i.v.)] was given if required. Local anesthetic consumption, need for rescue tramadol and post-operative nausea and vomiting (PONV) treatment, and patient's satisfaction were recorded during first 24-h infusion. Cost calculations were based on the acquisition cost of drugs and devices. Results:, Both techniques were similarly effective, but local anesthetic consumption and need for rescue analgesics were lower in the Stimulating group [respectively, 120 vs. 153 ml (P= 0.004) and 21% vs. 60% (P= 0.001)]. The analgesia-related costs for 24 h were similar when 100-ml bags of ropivacaine 2 mg/ml were used (66 , vs. 67 ,; P= 0.26). When 200-ml bags of ropivacaine were used, the analgesia-related costs were higher in the Stimulating group than the Conventional group (75 , vs. 55 ,; P= 0.0005). Conclusions:, Direct costs of continuous sciatic nerve block ranged from 55 to 75 ,. Stimulating catheters reduced local anesthetic consumption and need for rescue analgesics. This was only cost effective when 100-ml bags of 2 mg/ml ropivacaine were used, while the cheapest combination was the use of conventional catheters and 200-ml bags of ropivacaine. [source]

Self-sterilizing catheters with titanium dioxide photocatalyst thin films for clean intermittent catheterization: Basis and study of clinical use

INTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2007
Yuki Sekiguchi
Objective: Clean intermittent catheterization (CIC) requires a large number of disposable catheters or a large amount of water and disinfectant. We made titanium dioxide (TiO2)-coated catheters for CIC using technology we have developed previously, and examined the photocatalytic antibacterial effect of this catheter using only light energy and the safety of this type of catheter for practical clinical use. Methods: TiO2 -coated catheters were filled with bacterial cell suspensions and illuminated with a 15-W black-light lamp for testing antibacterial potency. Next, we soaked control toxic materials (zinc diethyldithiocarbamate) and the tips of TiO2 -coated catheters in M05 medium, and evaluated cell toxicity from the numbers of V79 colonies in these dilutions. Then, bodyweight curves and histological tissue changes were observed over a period of time in mouse-transplanted TiO2 -coated catheters and control catheters. Finally, we investigated the use of these TiO2 -coated catheters in 18 patients by questionnaire and bacterial culture of TiO2 -coated catheters and control catheters. Results: The survival rate of Escherichia coli in the liquid inside the TiO2 catheter decreased to a negligible level within 60 min under ultraviolet (UV)-A illumination. The survival rate of Staphylococcus aureus, Pseudomonas aeruginosa and Serratia marcescens also decreased to a negligible level within 60 min. V79 cells showed no cytotoxicity of this catheter, and there was no difference in bodyweight or foreign body reaction between mouse-transplanted TiO2 -coated catheters and control catheters. In a preliminary clinical analysis of 18 patients who voluntarily used this catheter, the rate of positive bacterial culture of the tips of TiO2 -coated catheters was 20% versus 60% for conventional catheters after 4 weeks of use. Conclusion: TiO2 -coated silicone catheters were easily sterilized under certain light sources and were shown to be safe in an experiment using cultured cells and in animal experiments. Sterilizing catheters with TiO2 photocatalyst thin films are expected to be used clinically for clean intermittent catheterization after proper modification based on this study. [source]

Catheter Ablation of Common-Type Atrial Flutter Guided by Three-Dimensional Right Atrial Geometry Reconstruction and Catheter Tracking Using Cutaneous Patches:

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2004
A Randomized Prospective Study
Introduction: EnSite® NavXÔ (NavX) is a novel mapping and navigation system that allows visualization of conventional catheters for diagnostic and ablative purposes and uses them to create a three-dimensional (3D) geometry of the heart. NavX is particularly suitable for ablation procedures utilizing an anatomic approach, as in the setting of common-type atrial flutter (AFL). The aim of this study was to compare NavX-guided and conventional ablation procedures for AFL. Methods and Results: Forty consecutive patients (32 male, 59 ± 12 years) with documented AFL were randomized to undergo fluoroscopy-guided (group I, 20 patients) or NavX-guided (group II, 20 patients) ablation, including 3D isthmus reconstruction. The same catheter setup was used in both groups. The endpoint of bidirectional isthmus block was obtained in all patients. Compared to conventional approaches, NavX-guided procedures significantly reduced fluoroscopy time (5.1 ± 1.4 min vs 20 ± 11 min, P < 0.01) and total x-ray exposure (5.1 ± 3.1 Gycm2 vs 24.9 ± 1.6 Gycm2, P < 0.01). Isthmus geometry reconstruction could be performed in all patients of group II. In 4 patients (20%) of group II, anatomic isthmus variations were detected by NavX. No significant differences in radiofrequency current applications and procedural times were found between the two groups. Conclusion: NavX technology allows geometry reconstruction of the cavotricuspid isthmus. NavX-guided ablation of AFL reduces total x-ray exposure compared to the fluoroscopy-guided approach but does not prolong procedure time. [source]

Stimulating or conventional perineural catheters after hallux valgus repair: a double-blind, pharmaco-economic evaluation

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2006
A. Casati
Background:, We prospectively evaluated direct analgesia-related costs of continuous sciatic nerve block using either a stimulating or conventional catheter after hallux valgus repair. Methods:, The perineural catheter was inserted through a stimulating introducer either blindly (group Conventional, n= 38) or while stimulating via the catheter (group Stimulating, n= 38). Nerve block was induced with 25 ml of mepivacaine 15 mg/ml, and was followed 3 h later by a patient-controlled infusion of ropivacaine 2 mg/ml (basal infusion: 3 ml/h; incremental dose: 5 ml; lock-out time: 30 min). Rescue tramadol [100 mg intravenous (i.v.)] was given if required. Local anesthetic consumption, need for rescue tramadol and post-operative nausea and vomiting (PONV) treatment, and patient's satisfaction were recorded during first 24-h infusion. Cost calculations were based on the acquisition cost of drugs and devices. Results:, Both techniques were similarly effective, but local anesthetic consumption and need for rescue analgesics were lower in the Stimulating group [respectively, 120 vs. 153 ml (P= 0.004) and 21% vs. 60% (P= 0.001)]. The analgesia-related costs for 24 h were similar when 100-ml bags of ropivacaine 2 mg/ml were used (66 , vs. 67 ,; P= 0.26). When 200-ml bags of ropivacaine were used, the analgesia-related costs were higher in the Stimulating group than the Conventional group (75 , vs. 55 ,; P= 0.0005). Conclusions:, Direct costs of continuous sciatic nerve block ranged from 55 to 75 ,. Stimulating catheters reduced local anesthetic consumption and need for rescue analgesics. This was only cost effective when 100-ml bags of 2 mg/ml ropivacaine were used, while the cheapest combination was the use of conventional catheters and 200-ml bags of ropivacaine. [source]