Catheter Design Must Change to Prevent Serious Complications From Wrong-Route Injection, Physicians Say

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Changes in catheter system design are necessary to prevent serious complications caused by injection of drugs into the wrong location, according to an editorial in the March issue of Anesthesia & Analgesia.

David J. Birnbach, MD, MPH, of the University of Miami Miller School of Medicine, and Charles A. Vincent, PhD, of Imperial College London issued a "call to action" on the problem of wrong-route injections in anesthesia. The editorial was inspired by continued reports of devastating complications caused by the injection of drugs intended for IV use into spine or epidural space — or the "even more dangerous" injection of epidural drugs into the general circulation.

The authors said that there has been no "necessary consensus, pressure and motivation" in the United States or Europe to address the problem. While other types of accidental drug administrations have been eliminated by designing systems that make it difficult to inject the wrong drug into the wrong catheter, such systems have yet to be developed for epidural or spinal catheters.

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