A comparison of two epidural catheter connectors

Background

Disconnection of the filter from its catheter is an established problem with epidural analgesia. Previously, it has been hypothesised that the screw cap connector is more prone to disconnection than the clamp connector design. The aim of this study was to test which of two mechanisms connecting the epidural catheter and filter was more prone to disconnection.

Methods

We recruited 20 consultant anaesthetists. First, each was asked to assemble an epidural set, either B Braun or Portex, in their normal way. Second, each anaesthetist assembled an epidural set, either B Braun or Portex, but was asked if they could improve the security of the connection, whilst avoiding catheter lumen occlusion. Each assembled set was then tested to determine adequacy of catheter connection using a standard protocol. Statistical analysis was performed using the Fisher’s exact test.

Results

The strength of the connection of the B Braun epidural set was similar to the Portex set when assembled for everyday practice (mean 1100 g; median 1100 g; SD 249 vs. mean 920 g; median 1050 g; SD 603). However, the incidence of inadequate connection was 0 in the B Braun group vs. 5 (25%) in the Portex group (P = 0.04). It was possible to improve the reliability of the Portex system, although episodes of weak connection were not eliminated.

Conclusions

We conclude that the Portex connection system is more prone to disconnection and that connection design is an important consideration when trying to minimise catheter disconnection.