title: Paraesthesia during the needle-through-needle and the double segment technique for combined spinal epidural anaesthesia.
abstract: Paraesthesia during regional anaesthesia is an unpleasant sensation for patients and, more importantly, in some cases it is related to neurological injury. Relatively few studies have been conducted on the frequency of paraesthesia during combined spinal epidural anaesthesia. We compared two combined spinal epidural anaesthesia techniques: the needle-through-needle technique and the double segment technique in this respect. We randomly allocated 116 parturients undergoing elective Caesarean section to receive anaesthesia using one of these techniques. Both techniques were performed using a 27G pencil point needle, an 18G Tuohy needle, and a 20G multiport epidural catheter from the same manufacturer. The overall frequency of paraesthesia was higher in the needle-through-needle technique group (56.9% vs. 31.6%, p = 0.011). The frequency of paraesthesia at spinal needle insertion was 20.7% in the needle-through-needle technique group and 8.8% in the double segment technique group; whereas the frequency of paraesthesia at epidural catheter insertion was 46.6% in the needle-through-needle technique group and 24.6% in the double segment technique group.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 135-710, 50 Ilwon-dong, Kangnam-ku, Seoul, Korea. hjahn@smc.samsung.co.kr
authors.forename: H J
authors.initials: HJ
authors.lastname: Ahn
authors.forename: D H
authors.initials: DH
authors.lastname: Choi
authors.forename: C S
authors.initials: CS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000767:Anesthesia, Epidural / Q000009:adverse effects* / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000379:methods; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007431:Intraoperative Complications; D009339:Needles; D010292:Paresthesia / Q000209:etiology*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011247:Pregnancy