Improving Epidural Catheter Fixation using Benzoin Tincture with Transparent Film Dressing for Postoperative Pain Control: A Randomized Controlled Trial
Orawan Pongraweewan MD1, Vimolluck Sanansilp MD1, Sucheera Rattanamung MD1, Supranee Namsawat MD1, Piyawadee Rungmongkolsab BNS1, Namtip Triyasunant MD1, Sahatsa Mandee MD1, Mingkwan Wongyingsinn MD1, Suvit Soontarinka MD1
Affiliation : 1 Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate the incidences of the peeling-off of transparent dressings and the migration of epidural catheters after the
application of benzoin tincture.
Materials and Methods : This double-blinded, randomized controlled trial was performed on 552 patients receiving continuous
epidural analgesia after abdominal and thoracic surgeries at Siriraj Hospital. Patients were equally allocated into 2 groups. In
“Group B”, patients were painted before the placement of dressings with benzoin tincture on the skin and the epidural catheters;
the tincture was provided in ready-to-use packs produced by the Division of Pharmacy, Siriraj Hospital. In “Group T”, patients
were not painted. Photos were taken upon completion of the dressings, at the finish of operations, and once daily until the
dressings were removed. The dressings were assessed by two independent researchers who did not know the patient groups.
Results : A total of 523 patients were analyzed. The incidences of the whole sheet peeling off, and the consequential need for
redressing as the catheters were no longer secured, were 71 (27.8%) in Group T and 47 (17.5%) in Group B (p = 0.005). This gave
the number needed to benefit of 9.7, 95% confidence interval [CI] 5.75 to 31.92; absolute risk reduction 0.10, 95% CI 0.03 to
0.17; relative risk 0.55, 95% CI 0.39 to 0.77; and relative risk reduction 0.4505, 95% CI 0.22-0.6. The overall migration of the
catheters was significantly less in the benzoin tincture group.
Conclusions: Applying benzoin tincture on the skin and epidural catheters before placing transparent film dressings significantly
reduced the incidences of dressing peeling off and migration of the epidural catheter on the second postoperative day.
Keywords : Benzoin tincture, Transparent film dressing, Epidural catheter, Epidural catheter migration, Continuous epidural analgesia, Postoperative analgesia
