Anesth Analg 2001;92:1074-1075
© 2001 International Anesthesia Research Society
LETTERS TO THE EDITOR
Difficult Insertion of Interscalene Brachial Plexus Catheter
F. J. Singelyn, MD, PhD
Department of Anesthesiology, Cliniques Universitaires St Luc, Brussels, Belgium
I read the article by Klein et al. (1) with interest. They stated in the discussion "Recently, Singelyn et al. reported use of continuous interscalene anesthesia and noted that 84% (21 of 25) of the catheters were very difficult to insert." They are, however, mistaken. In our study (2), a difficult (i.e., more than two attempts) insertion of the catheter was noted in 8 of 60 patients, an incidence of 13%. The statement that "This (such high incidence) contrasts with the ease and success of catheter insertion in this study" (1) is thus questionable. As the authors did not provide their own incidence of difficult catheter insertion, the suggested superiority of their equipment is not substantiated by data and remains controversial.
References
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Klein SM, Grant SA, Greengrass RA, et al. Interscalene brachial plexus block with a continuous catheter insertion system and a disposable infusion pump. Anesth Analg 2000; 91: 1473–8.[Abstract/Free Full Text]
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Singelyn FJ, Seguy S, Gouverneur JM. Interscalene brachial plexus analgesia after open shoulder surgery: continuous versus patient-controlled infusion. Anesth Analg 1999; 89: 1216–20.[Abstract/Free Full Text]
Response
Stephen M. Klein, MD,
Roy A. Greengrass, MD,
Karen Nielsen, MD, and
Susan M. Steele, MD
Department of Anesthesiology, Duke University Medical Center, Durham, NC
In Response: We thank Dr. Singelyn for pointing out the incorrect reference in our manuscript (1). The reader should refer rather to Table 4 of their article citing technical difficulties (2). This reference is not made to impugn one technique or draw a direct comparison between the equipment, as this was not the focus of the article or intention. Rather, our goal is to draw attention to the fact that improved equipment is still needed for this application.
References
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Klein SM, Grant SA, Greengrass RA, et al. Interscalene brachial plexus block with a continuous catheter insertion system and a disposable infusion pump. Anesth Analg 2000; 91: 1473–8.
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Singelyn FJ, Seguy S, Gouverneur JM. Interscalene brachial plexus analgesia after open shoulder surgery: continuous versus patient-controlled infusion. Anesth Analg 1999; 89: 1216–20.
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