Epiduroscopic changes in patients undergoing single and repeated epidural injections.
Using a superfine fiberscope with an outer diameter of 0.75 mm, the effect of repeated injections through a single epidural catheter on the epidural space was examined in 18 patients. The subjects were divided into a control group of 10 patients who had not previously received epidural anesthesia (EA) and an EA group of 8 patients who had received repeated EA with 4-6 mL 0.25% bupivacaine through an epidural catheter, two to three times per day for 7-14 days. The epidural space was observed through a fiberscope passed through a 17-gauge Tuohy needle. The epidural space was occupied by large masses of fat, and the blood vessels and connective tissue were confirmed. Adverse reactions in the epidural tissue, such as hemorrhage or congestion with engorgement, were observed in four patients in the EA group. Five patients in the EA group experienced pain when the fiberscope was inserted into the epidural space. These investigations show that continuous EA might be followed by a high incidence of nonspecific epidural changes. Superfine fiberscope may be useful in the detection or diagnosis of local epidural reaction.
Kitamura
A
A
Department of Anesthesiology, Nippon Medical School, Tokyo, Japan.
Sakamoto
A
A
Aoki
S
S
Ogura
A
A
Kawahara
T
T
Inoue
T
T
Ogawa
R
R
D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D004824:Epidural Space / Q000033:anatomy & histology*; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods; D006801:Humans; D007268:Injections, Epidural; D008297:Male; D008875:Middle Aged