A wound soaker catheter is most commonly used for limb amputations and is surgically embedded or placed during wound closure (eg, at the level of the brachial plexus). It is flexible and easily removed, and can deliver a constant rate infusion of a local anesthetic. It is commonly used in human medicine to provide perioperative pain relief and decrease the overall amount of opioids used. The authors investigated wound soaker catheter placements in 52 dogs, 2 cats, and 2 goats to characterize reason for placement, potential for infection, and potential for toxicities or other complications. Local anesthetics administered were 2% lidocaine as a constant rate infusion, or 0.5% bupivacaine given as an intermittent bolus Q 6 H. The most common reason for catheter use was amputation due to neoplasia (specifically, osteosarcoma). The most common complication noted was disconnection of the catheter from its continuous infusion; increased rate of infection was not identified. One patient exhibited signs of neurotoxicity secondary to lidocaine that diminished after cessation of the infusion. The authors concluded that using a wound soaker catheter is a viable method for providing analgesia to surgical patients.
Commentary: Overall, this appears to be an exciting and novel technique for comprehensive pain control. Further characterization of the technique might investigate differences in dosing and the need for postoperative opiates; pain scoring of patients receiving catheters; and comparing epidural to wound soaking catheters for pelvic limb amputations. It would also be useful for the authors to describe and illustrate different methods.
Use of wound soaker catheters for the administration of local anesthetic for post-operative analgesia: 56 cases. Abelson AL, McCobb EC, Shaw S, et al. VET ANAESTH ANALG 36:597-602, 2009.