Straight advancement of epidural catheter--comparative assessments by method and site of epidural needle puncture and angle of puncture.
The catheter straight advancement rate for introduction into the epidural space was investigated using a radiopaque catheter. One hundred patients were divided into two groups and underwent thoracic or lumbar epidural punctures, with one of two different puncture methods: the median approach or paramedian approach. Two different angles of epidural puncture needle insertion, 50-60 degrees and 90 degrees to skin surface plane, were used. A catheter was inserted into the epidural space about 5 cm cephalad and the course of the inserted catheter was ascertained by radiography. The results have shown that punctures performed at an insertion angle of 50-60 degrees yielded higher catheter straight advancement rates than those performed at an angle of 90 degrees in both thoracic and lumbar epidural punctures.
Department of Anesthesiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan. takeyama@is.icc.u-tokai.ac.jp
Kazuhide
K
Takeyama
Hajime
H
Yamazaki
Miho
M
Maeda
Kyoko
K
Tomino
Toshiyasu
T
Suzuki
D000767:Anesthesia, Epidural / Q000295:instrumentation; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D004824:Epidural Space / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae; D008161:Lumbosacral Region; D011859:Radiography; D013131:Spine / Q000000981:diagnostic imaging; D013904:Thoracic Vertebrae