title: The influence of patient position on withdrawal force of thoracic epidural catheters.
abstract: We investigated the forces required to remove thoracic epidural catheters to determine the effect of patient position on removal. Eighty-four patients undergoing open thoracotomy and thoracic patient-controlled epidural analgesia were enrolled. Catheterisation was performed under fluoroscopic guidance before surgery, and the patients were allocated to one of three position groups for removal: prone; sitting; and lateral. On the third postoperative day, the peak tension during withdrawal in the assigned position was measured. No differences in mean (SD) forces were found between groups: prone 1.61 (0.39) N, supine 1.62 (0.61) N and lateral 1.36 (0.56) N (p = 0.140). The withdrawal forces required to remove thoracic epidural catheters were not affected by the position. Thus, the position for removal can be determined by patient's choice and clinical judgement.
authors.affiliation:  Associate Professor.
authors.forename: W S
authors.initials: WS
authors.lastname: Sim
authors.affiliation:  Clinical Fellow.
authors.forename: J W
authors.initials: JW
authors.lastname: Choi
authors.affiliation:  Medical Director, Zeropain Pain Treatment Clinic, Seoul, Korea.
authors.forename: C J
authors.initials: CJ
authors.lastname: Lee
authors.affiliation:  Assistant Professor, Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: F S
authors.initials: FS
authors.lastname: Nahm
authors.affiliation:  Clinical Assistant Professor.
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.affiliation:  Associate Professor.
authors.forename: B S
authors.initials: BS
authors.lastname: Shin
authors.affiliation:  Professor, Department of Anaesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Cho
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015360:Analgesia, Epidural / Q000295:instrumentation / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000767:Anesthesia, Epidural / Q000295:instrumentation / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D002404:Catheterization; D057785:Catheters; D020878:Device Removal; D004824:Epidural Space / Q000000981:diagnostic imaging; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D056888:Patient Positioning; D011187:Posture / Q000502:physiology*; D016684:Prone Position / Q000502:physiology; D011446:Prospective Studies; D018401:Sample Size; D012737:Sex Factors; D013904:Thoracic Vertebrae
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004091:Hydromorphone; D002045:Bupivacaine