Evaluation of two different epidural catheters in clinical practice. narrowing down the incidence of paresthesia!
Although epidural anesthesia is considered safe, several complications may occur during puncture and insertion of a catheter. Incidences of paresthesia vary between 0.2 and 56%. A prospective, open, cohort-controlled pilot study was conducted in 188 patients, ASA I-III, age 19-87 years, scheduled for elective surgery and epidural anesthesia. We evaluated a 20 G polyamide (standard) catheter and a 20 G combined polyurethane-polyamide (new) catheter. Spontaneous reactions upon catheter-insertion, paresthesia on questioning, inadvertent dural or intravascular puncture, and reasons for early catheter removal were recorded. The incidence of paresthesia reported spontaneously was 21.3% with the standard catheter and 16.7% with the new catheter. Systematically asking for paresthesia almost doubled the paraesthesia rate. Intravascular cannulation occurred in 5%. No accidental dural punctures occurred. An overall incidence of 13.3% of technical problems led to early catheter removal. The new catheter was at least equivalent to the standard regarding epidural success rate and safety : rate of paresthesia, intravascular and dural cannulation.
Bouman
E A C
EA
University Hospital Maastricht, Department of Anesthesiology, Maastricht, The Netherlands. eabo@sane.azm.nl
Gramke
H F
HF
Wetzel
N
N
Vanderbroeck
T H T
TH
Bruinsma
R
R
Theunissen
M
M
Kerkkamp
H E M
HE
Marcus
M A E
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural / Q000009:adverse effects* / Q000295:instrumentation*; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D010865:Pilot Projects; D011446:Prospective Studies