Intrapartum epidural fixation methods: a randomised controlled trial of three different epidural catheter securement devices

Abstract

This randomised controlled trial investigated the efficacy of Epi-Fix(™) , LockIt Plus(®) and Tegaderm(™) as fixation devices for intrapartum epidural catheters. One hundred and sixty-five women requesting intrapartum epidural analgesia were randomised to receive different fixation devices to secure their epidural catheter. The amount of epidural catheter migration (measured to the nearest 0.5 cm) was analysed for three devices: Epi-Fix (n = 55); LockIt Plus (n = 54); and Tegaderm dressing (n = 51). Median (IQR [range]) catheter migration for Epi-Fix was 1.0 cm (0.0-2.0 [-2.0 to 9.5]), vs 0.0 cm (0.0-0.5 [-1.0 to 5.5]) for LockIt Plus and 0.5 cm (0.0-1.8 [-1.5 to 8.0]) for Tegaderm (p = 0.003). Thirty-eight (69.1%) epidural catheters secured with Epi-Fix migrated < 2.0 cm, compared with 49 (90.7%) with LockIt Plus and 40 (78.4%) with Tegaderm. Sixteen epidural catheters required resiting due to failure of analgesia of which 12 (75.0%) occurred in patients with epidural catheters that had migrated ≥ 2.0 cm. This study shows that intrapartum epidural catheters secured with the LockIt Plus device exhibit less catheter migration compared with fixation with Epi-Fix and Tegaderm.