The continuous femoral nerve block catheter for postoperative analgesia: Bacterial colonization, infectious rate and adverse effects

We investigated the incidence of bacterial and vascular or neurological com plications resulting from femoral nerve catheters used for postoperative an algesia. Patients requiring continuous femoral blockade were consecutively included. Using surgical aseptic procedure, 211 femoral nerve catheters wer e placed (short-beveled insulated needle, peripheral nerve stimulator). Aft er 48 h, each catheter was removed and semiquantitative bacteriological cul tures were performed on each distal catheter tip. Postoperative analgesia a nd antibiotics were standardized. All complications during the insertion of the catheters and postoperatively (after 48 h and 6 wk) were noted. Few in itial complications with no immediate or delayed complications were noted ( 20 difficult insertions, 3 impossible injections, 3 ineffective catheters, and 12 vascular punctures). After 48 h, 208 catheters were analyzed; 57% ha d positive bacterial colonization (with a single organism in 53%). The most frequent organisms were Staphylococcus epidermidis (71%), Enteroccus (10%) , and Klebsiella (4%). Neither cellulitis nor abscess occurred. Three trans itory bacteriemias likely related to the catheter occurred. After 6 wk, no septic complications were noted. One femoral paresthesia, partially recover ed I yr later, was noted. We conclude that the risk of bacterial complicati ons is small with femoral nerve catheters, although the rate of colonizatio n is frequent.