title: Technical problems associated with the use of 32-gauge and 22-gauge spinal catheters.
abstract: Interest in the use of continuous spinal anaesthesia (CSA) has recently increased because of the availability of new, extremely thin catheters. In this study the use of 32-gauge (G) catheters was compared with 22-G catheters in operations on the lower limb and for the administration of intrathecal morphine in the postoperative period in 42 elderly patients. CSA succeeded in 34 cases and 8 patients were anaesthetised with a single-shot spinal method. No general anaesthesia was needed. Technical problems with the subarachnoid puncture with the 19-G needle caused two failures in the 22-G group. In a group of 20 patients, there were five failures with the 32-G catheter, as opposed to one failure with the 22-G catheter in a group of 20 patients. Associated with morphine injection through the 32-G catheter, the syringe or connector was inadvertently disconnected in four cases and a tear of the catheter wall was observed in one case. Such problems did not occur with the 22-G catheter. Postdural puncture headache did not occur, and there was no difference in the incidence of patient-reported postoperative complications between the two groups. It is concluded that both the insertion and maintenance of the thin (32-G) subarachnoid catheters are associated with more technical problems than the 22-G catheter.
authors.affiliation: Department of Anaesthesiology, Helsinki University Central Hospital, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Silvanto
authors.forename: M
authors.initials: M
authors.lastname: Pitkänen
authors.forename: M
authors.initials: M
authors.lastname: Tuominen
authors.forename: P H
authors.initials: PH
authors.lastname: Rosenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000295:instrumentation*; D002404:Catheterization / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D009983:Orthopedic Equipment; D010149:Postoperative Pain / Q000517:prevention & control*
chemical_list: D009020:Morphine