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Ferrosan Medical Devices is committed to clinical research to establish objective and documented evidence for the real difference our products make to the doctors, patients and nurses who use them. Already now two articles have been published in peer-reviewed journals and more will follow from the ongoing clinical trials.

 

Published articles

'A novel concept for continuous peripheral nerve blocks. Presentation of a new ultrasound-guided device.'
Rothe, C. et al., Acta Anaesthesiology Scandinavica 2015, Feb; 59 (2): 232-7.

'A novel suture method to place and adjust peripheral nerve catheters.'
Rothe, C. et al., Anaesthesia 2015, July; 70 (7): 791-6.

'Initial placement and secondary displacement of a new suture-method catheter for sciatic nerve block in healthy volunteers: a randomised, double-blind pilot study.'
T. S. Lyngeraa et al. Anaesthesia 2017, Aug; 72(8): 978-986.

 

Posters

PDF downloadTuyakov, B. et al., Continuous peripheral nerve block (CPNB) with the use of Certa Catheter™. Case series, Presented at the 35th Annual ESRA Congress 2016, Maastricht, The Netherlands.

 

PDF downloadLyngeraa, T. S. et al., Primary placement and secondary repositioning of a new suture-method catheter for continuous adductor canal block, Presented at the 35th Annual ESRA Congress 2016, Maastricht, The Netherlands.

 

PDF downloadChristiansen, C. B. et al., Dose response relationship for ropivacaine 0.2% on common peroneal nerve block duration and nerve block duration variability: A randomized, blinded study in healthy volunteers.

 

PDF downloadMadsen, M. H. et al., The effect of local anesthetic infusion rates on common peroneal nerve block duration: A randomized, blinded study in healthy volunteers.

 

Interactive model and Certa Catheter™ videos

Selected cases

For inspirational use please find different videos showing Certa Catheter™ for Adductor Canal, Femoral Nerve and Interscalene Brachial Plexus.For ease of use please click on the below interactive model and you will be directed to the requested video.

 

Interscalene Brachial Plexus
Femoral Nerve
Adductor Canal
Guide to choosing insertion point
Removal

 

Interscalene Brachial Plexus
Certa Catheter™

Transducer: High frequency, linear.
Approach:   Short axis, in plane.
Catheter:    Certa Catheter™ R50.

Technique: Posterior approach. Plan insertion and exit site before skin puncture.
Observe the position of the external jugular vein and the phrenic nerve (if possible).
Advance the needle in the medial scalene muscle - avoid vessels and nerves in the muscle.
Position the tip of the needle under the superior root or divisions in the interscalene space to reduce the risk of nerve injury during needle advancement.
Hydrodissect to confirm the position of the needle tip and local anaesthetic spread.
The needle tip is retracted and moved clockwise in the hydrodissected space posterior and above the plexus and advanced further through the subcutaneous tissue.
Remove the transducer after observing that there are no important structures in the needle trajectory and advance the needle through the skin at the planned exit site.

 

 

 

Femoral Nerve
Certa Catheter™

Transducer: High frequency, linear.
Approach: Short axis, in plane.
Catheter: Certa Catheter™ R50 or R75 (depending on the anatomy).

Technique: Transverse approach at the femoral crease level.
Plan insertion and exit site before skin puncture.
Advance the needle in the sartorius muscle into the iliopsoas muscle lateral to the femoral nerve - avoid vessels and nerves in the muscle. Position the tip beneath the iliac fascia.
Hydrodissect to confirm the position of the needle tip and advance the needle tip in the space created by local anaesthetic. Reposition the needle if the spread of local anaesthetic is not in close relation to the femoral nerve. Position the needle tip above the femoral nerve and observe the spread of local anaesthetic. Exit superficial to the femoral artery. Remove the transducer after observing that there are no important structures in the needle trajectory and advance the needle through the skin at the planned exit site.

 

 

 

Adductor Canal
Certa Catheter™

Transducer: High frequency, linear.
Approach: Short axis, in plane.
Catheter: Certa Catheter™ R75.

Technique: Transverse approach at the mid-thigh level.
Plan insertion and exit site before skin puncture.
Advance the needle in the vastus medialis muscle - avoid vessels and nerves in the muscle.
Position the tip of the needle in the adductor canal.
Hydrodissect to confirm the position of the needle tip and local anaesthetic spread.
The needle tip is positioned above the saphenous nerve.
Exit superficial to the femoral artery through the sartorius muscle and further through the subcutaneous tissue.
Remove the transducer after observing that there are no important structures in the needle trajectory and advance the needle through the skin at the planned exit site.

 

 

 

Guide to choosing insertion point
for the Certa Catheter™

The Certa Catheter™ is different from a straight needle because the needle is curved and therefore describes a curved trajectory. This allows in-plane ultrasound guidance throughout the procedure both during initial positioning as well as during later in-plane readjustment of the Certa Catheter™, if needed. The advantage of the product design is a precise initial placement of the catheter.

During the pre-puncture scan, it is advisable to plan the trajectory to get the catheter into the best position and avoid important structures. In the beginning of the learning curve, a drawing can help to estimate the insertion point and the exit point. This guide is a simple 3-step approach for planning of the insertion and exit point when using Certa Catheter™.
Certa Catheter™ should always be inserted and placed under ultrasound guidance.

Adductor canal block is used as an example but the guide is universal for all nerve blocks. For detailed product information, please refer to the Certa Catheter™ Instructions for Use.

 

 

Removal of Certa Catheter™

Principle of removal: Sterile technique. Follow guidelines provided by the institution or hospital.

Directions:

  • Remove the adhesive patch from the catheter exit site
  • Keep the adhesive patch in place at the entry site in order to maintain fixation of the entry point of the catheter during removal of the exit patch
  • Pull the distal end of the catheter at the exit hole gently to fully expose its surface at skin level
  • The distally protruding catheter including the perforation site, the surrounding skin and the cutting zone is thoroughly disinfected twice. Use a standard antiseptic solution as per the institution’s or hospital’s guideline
  • Still maintaining the gentle pull, cut off the distal end of the catheter just above skin level at the exit hole using a pair of sterile scissor
  • Do not pull the catheter through the skin
  • At the insertion site, remove the remaining adhesive patch and gently pull the catheter out
  • Perform standard observations of skin penetration sites for unusual bleeding, bruishing, swelling or redness.
  • A small amount of bleeding is not uncommon at the catheter skin penetration sites.
  • This can be controlled with light pressure and a sterile dressing

Important information:

  • If the catheter cannot be easily removed or patient experiences pain or paraesthesia during initial traction, stop the removal process and seek expert advice.
  • Inspect the catheter to confirm complete removal

 

Certa Catheter™ – Clinical Use and Experience  

Less pain after surgery with Certa Catheter™

Patient 'X'; a woman in her early 50's, has had Certa Catheter™ inserted in conjunction with a shoulder operation, where a purification of the shoulder joint and loosening of the joint capsule, has been carried out. Patient 'X' requested herself to get Certa Catheter™ inserted because of fibromyalgia; 'X' says: "Due to the fibromyalgia I am much more sensitive to pain."

"Before the operation I had terrible pains in my shoulder and arm; my night sleep was affected, I had to cancel holidays and daily things like washing hair, combing hair and getting dressed caused major difficulties."

"Before the surgery I had heard about the pain catheter (Certa Catheter™). Therefore, I agreed with the anaesthetist to have one inserted, to reduce the pain associated with the surgery." "After the operation the pain catheter was inserted, gently and painlessly by the anaesthetist, though due to severe neck pain caused by my fibromyalgia, it was an uncomfortable feeling to be located one side. Afterwards, I was taken to the ward and the nurses gave medications directly in the pain catheter; at first 3 times a day and afterwards I got a pump."

"Pains have been a part of my life for the last ten years or more, due to arthritis and a bad back in addition to the fibromyalgia. I expected the pain catheter would help reducing the pains after surgery and my expectations were fully met. After surgery, I continued to use the pain catheter until I was discharged. It was a nurse who removed the pain catheter, painlessly."

"At present I am in the process of regaining my strength and mobility in my arm and shoulder. It is tough. The operation of the other shoulder is not yet planned, but it will most likely be within the next few years. Due to my chronic pains, I will definitely request for the pain catheter again – as a patient, it made a huge difference to me. Next time I hope the bag for storing the pump has a slightly longer strap, as it will give increased mobility".


The patient had the Certa Catheter™ placed at Nordsjaelland’s hospital in Denmark by one doctor from the anaesthesiology department during the month of February 2016.
The person has not received any payment for sharing her experiences with Certa Catheter™.

Certa Catheter™ was used in a Lateral Infraclavicular (LIC) insertion

Certa Catheter™ in a LIC insertion was performed similar to a traditional single shot LIC approach in regards to transducer placement, anatomic landmarks and initial skin penetration and needle advancement, using a standard linear transducer (5-12 MHz) and a Certa Catheter™ REF R50A1. After administering Local anaesthetics (LA) in proximity to the profound pole of the axillary artery, between the posterior and the lateral cord of the brachial plexus and with a sufficient spread of LA in direction of the medial cord, the needle tip was advanced superficial of the artery until the point of skin-exit 2cm medially of the anterior axillary fold. The Certa Catheter™ had remarkable analgesic effect.

 Certa Lateral Infraclavicular

 

 

Ferrosan Medical Devices Sp. z o.o.
ul. Koksowa 3
70-031 Szczecin, Poland

Contact details:
Tel.: +48 91 4283 400
infopl@ferrosanmd.com

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