title: [The direction and the position of epidural catheter tips inserted 5 cm or 7 cm cephalad did not differ].
abstract: BACKGROUND
  Epidural catheter insertion is a common procedure in gynecological surgeries. At a previous study, we investigated the catheter's direction and position, inserted 7cm cephalad from T12-L1, with postoperative plain X-P using picture archiving communication system (PACS). 74% of the catheters advanced in cephalad direction and 71.4% of the catheter tips stayed within one vertebra from the puncture level. We estimated that the catheters were too long to advance straight. Then, we planned another prospective study to compare the catheter advanced 7 cm or 5 cm regarding its direction and tip position.
  
  
  METHODS
  Fifty-one female patients receiving gynecological surgery were enrolled. Epidural catheters were inserted from T12-L1 intervertebral space in cephalad direction for the length of 5 cm confirmed with postoperative plain X-P using PACS. The catheter's direction, the length, and the position were verified and compared with the result of the previous study.
  
  
  RESULTS
  The catheters going cephalad appeared more frequently among 5 cm group than 7 cm group. Those going caudalad appeared more frequently among 7 cm group than 5 cm group. However, the catheter tip final position and the length from the puncture levels were not significantly different between the groups.
  
  
  CONCLUSIONS
  The direction and the position of epidural catheter inserted 5 cm or 7 cm cephalad did not differ.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo 136-0075.
authors.forename: Izumi
authors.initials: I
authors.lastname: Kawagoe
authors.forename: Keiko
authors.initials: K
authors.lastname: Tajima
authors.forename: Masanori
authors.initials: M
authors.lastname: Kanai
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Mitsuhata
mesh_terms: D000767:Anesthesia, Epidural / Q000379:methods; D002404:Catheterization / Q000379:methods*; D004824:Epidural Space; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies