title: Microcatheter continuous spinal anaesthesia in the post-operative period: a prospective study of its effectiveness and complications.
abstract: One hundred patients (aged 22-86 years, mean 62.5), undergoing lower limb orthopaedic surgery, received continuous spinal anaesthesia using a 28 s.w.g. catheter inserted through a 22 s.w.g. Quincke needle. Post-operative pain relief was provided by bolus injections of 1-2.5 mL 4 h-1 of plain 0.25% bupivacaine. The mean dose of bupivacaine required for sufficient pain relief in 93% of patients was 1.6 +/- 0.2 (1.3-1.9) mL 4 h-1. The highest dose was needed between 4 and 8 h post-operatively. No dependence of dose on age or type of operation was found. Technical problems with the microcatheter occurred in 12%. The most frequent complaint was post-operative backache (12%). Only one patient suffered from post-dural puncture headache on the day after surgery. There was no microbiological contamination of the catheter tips after removal. In the post-operative interview, 89% of the patients were completely satisfied with CSA; 91% would prefer this technique to general anaesthesia.
authors.affiliation: Department of Anaesthesiology, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Standl
authors.forename: S
authors.initials: S
authors.lastname: Eckert
authors.forename: J
authors.initials: J
authors.lastname: Schulte am Esch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000295:instrumentation / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011446:Prospective Studies
chemical_list: D002045:Bupivacaine