Uniport soft-tip, open-ended catheters versus multiport firm-tipped close-ended catheters for epidural labor analgesia: a quality assurance study.
OBJECTIVE
To compare a multiport, firm-tipped, close-ended, epidural catheter (Portex catheter) with a uniport, open-ended, soft-tipped, wire-reinforced catheter (Arrow catheter) in obstetric patients.


METHODS
Prospective data collection for intradepartmental quality assurance.


METHODS
Obstetric unit in a tertiary care maternity hospital.


METHODS
2612 patients requesting labor analgesia.


METHODS
The Arrow catheter was used in 1,352 women and the Portex catheter in 1,260 women.


RESULTS
The incidence of unsatisfactory block were 3.3% and 4.4% with the Arrow and Portex catheters, respectively (p = 0.2). The catheter perforated the dura matter in 0.4% of cases with both catheters. The incidence of epidural venipuncture was 1.1% with the Arrow catheter and 5.7% with the Portex catheter (p = 0.0001). Paresthesias occurred in 6% of cases with the Arrow catheter and 11. 2 % of cases with the Portex catheter (p = 0.0001). Epidural catheter reinsertion was required in fewer patients in the Arrow group than in the Portex group (4.8% vs. 7.1%; p = 0.01).


CONCLUSIONS
In obstetric patients, the softer uniport Arrow catheter produces paresthesias and venipunctures less frequently than the firm multiport Portex catheter.
Jaime
F
F
Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213-3180, USA.
Mandell
G L
GL
Vallejo
M C
MC
Ramanathan
S
S
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000295:instrumentation*; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000295:instrumentation*; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D016009:Chi-Square Distribution; D004388:Dura Mater / Q000293:injuries; D004824:Epidural Space / Q000098:blood supply; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D007743:Labor, Obstetric; D009757:Nylons; D010292:Paresthesia / Q000209:etiology; D011140:Polyurethanes; D011247:Pregnancy; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D013193:Stainless Steel; D013499:Surface Properties; D017749:Total Quality Management; D014680:Veins / Q000293:injuries
D009757:Nylons; D011140:Polyurethanes; D013193:Stainless Steel