title: Effects of predistention with normal saline containing adrenaline on blood-vessel injury during epidural catheter placement.
abstract: This study investigated the effects of predistention with normal saline containing adrenaline on vascular plexus injury during epidural catheter placement. Three hundred parturients undergoing caesarean sections were randomly divided into three groups. Group I (n = 102) received  an epidural injection with 5 ml normal saline; group II (n = 93) received 5 ml normal saline containing adrenaline (5 μg/ml); group III (n = 100) received direct epidural catheter placement. Five women were excluded from the analysis for technical reasons. The incidence of  bloody fluid in the epidural needle was significantly lower in groups I and II compared with group III (eight [7.8%] and seven [7.5%] versus 17 [17.0%], respectively). There were no significant differences in the incidence of bloody fluid in the epidural catheter or in the incidence of intravascular  epidural catheter placement between the three groups. Predistention with 5 ml normal saline before catheter insertion reduced the incidence of blood-vessel injury during epidural catheter placement, but adrenaline provided no additional protective effects.
authors.affiliation: Department of Anaesthesiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
authors.forename: C-B
authors.initials: CB
authors.lastname: Han
authors.forename: L
authors.initials: L
authors.lastname: Yu
authors.forename: Y-N
authors.initials: YN
authors.lastname: Qian
authors.forename: Z-N
authors.initials: ZN
authors.lastname: Ding
authors.forename: J-D
authors.initials: JD
authors.lastname: Jiang
authors.forename: Q-H
authors.initials: QH
authors.lastname: Zhou
authors.forename: J
authors.initials: J
authors.lastname: Sun
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D002404:Catheterization / Q000009:adverse effects*; D003710:Demography; D004837:Epinephrine / Q000008:administration & dosage* / Q000494:pharmacology*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects; D036801:Parturition / Q000187:drug effects; D012965:Sodium Chloride / Q000008:administration & dosage* / Q000494:pharmacology*; D057772:Vascular System Injuries / Q000209:etiology*
chemical_list: D012965:Sodium Chloride; D004837:Epinephrine