METHOD OF FIXING CATHETER UNDER THE SKIN OF THE SUBCLAVIAN REGION DURING PROLONGED BLOCKADE OF THE BRACHIAL PLEXUS Russian patent published in 2023 - IPC A61M19/00 A61B17/34 

FIELD: medicine; namely to anesthesiology and intensive care.

SUBSTANCE: invention can be used for fixing a catheter under the skin of the subclavian region during prolonged blockade of the brachial plexus. A 3 mm skin incision is made in a place located 10 mm above the upper edge of the clavicle along the anterior axillary line. Before installing the catheter to the brachial plexus, a large subcutaneous canal is first formed in the subclavian region using a Tuohy guide needle with an outer diameter of 1.3 mm and a length of 80 mm, through the lumen of which a spinal needle with an outer diameter of 0.5 mm and a length of 103 mm with a pencil sharpening of the distal end towards the proximal end of the Tuohy guide needle. Then the Tuohy needle is removed from under the skin of the subclavian region, while the distal end of the spinal needle is located in the wound at the site of access to the brachial plexus, then with the same Tuohy guide needle, under ultrasound control, access to the brachial plexus is performed, so that the distal end of the guide needle Tuohy is located under the brachial plexus. Subsequently, a catheter with an outer diameter of 0.85 mm and an internal diameter of 0.45 mm is brought through the lumen of the Tuohy guide needle to the brachial plexus, after which this Tuohy needle is removed. After that, the proximal end of the catheter is fixed on the distal end of the spinal needle, for which the distal end of the spinal needle is inserted into the lumen of the catheter at a distance of 3 mm, after which the spinal needle with the catheter fixed on it is removed from the large subcutaneous canal of the subclavian region. Next, a small subcutaneous canal is formed; for this, from a point located 7 mm medial to the first exit of the catheter from the large subcutaneous canal of the subclavian region, a Tuohy guide needle is passed in the caudal direction at a distance of 10 mm, then the spinal needle is passed through the lumen of the Tuohy guide needle from the side the distal end towards the proximal end, after which the Tuohy guide needle is removed from the small subcutaneous canal of the subclavian region, after which the proximal end of the catheter is fixed on the distal end of the spinal needle, for this purpose the distal end of this spinal needle is passed into the lumen of the catheter at a distance of 3 mm, then the spinal needle with the catheter fixed on it is removed from the small subcutaneous canal of the subclavian region, after which the proximal end is passed between the surface of the skin and the cutaneous portion of this catheter, located between the first exit of the catheter to the skin surface from the large subcutaneous canal and the entrance of the catheter into the small subcutaneous canal, forming a subcutaneous loop of the catheter. The exit point of the catheter in the subclavian region is attached to the skin with a patch sticker, and the proximal end of this catheter is connected to the catheter connector, which is then connected to an antibacterial filter, after which the antibacterial filter is attached to the skin of the subclavian region on the side opposite to the blocked limb with an antibacterial filter holder.

EFFECT: by placing a catheter under the skin of the subclavian region and forming a subcutaneous loop of the catheter, the method allows to increase the reliability of catheter fixation and reduce the risk of developing dislocation complications.

1 cl, 13 dwg, 1 ex