[The finding of glucose in the fluid obtained by epidural catheter after its insertion during combined intradural-epidural anaesthesia with hyperbaric bupivacaine is a usual occurrence].
OBJECTIVE
To determine whether the appearance of glucose in the fluid spontaneously obtained by the epidural catheter after its insertion during combined intradural-epidural anaesthesia with hyperbaric bupivacaine is a usual occurrence.


METHODS
A prospective, observational study was conducted on 34 patients with combined intradural-epidural anaesthesia in whom an epidural catheter was introduced, after locating the epidural space with a saline solution, inserting a spinal needle and injecting hyperbaric bupivacaine. After observing whether any fluid was spontaneously dripping from it, it was determined if this contained glucose. Withdrawal of the needle and washing its lumen with saline solution, it was checked whether there was glucose in washout. The samples were analysed using a glucose meter. When the motor block disappeared a dose of local anaesthetic was administered through the epidural catheter. The relationship of the demographic parameters with the spontaneous dripping of the epidural catheter was evaluated.


RESULTS
Spontaneous dripping by the epidural catheter after its insertion was observed in 22 patients. All the samples obtained contained glucose. There was glucose in 9 out of 34 epidural needle wash samples. None of the patients suffered from excessive motor-sensory block. There was a statistically significant relationship between patient age (P<.05) and spontaneous dripping by the catheter (the higher the age, more dripping).


CONCLUSIONS
The finding of glucose in the fluid obtained by the epidural catheter is a frequent occurrence and is of no clinical significance. We propose that it could be due to a leak of cerebrospinal fluid by the dural puncture needle during or after the administering of the hyperbaric bupivacaine and the spillage of this into the epidural space.
Servicio de Anestesiología y Reanimación, Hospital Universitario Dr. Peset, Valencia, España.
J
J
Sánchez Morillo
M J
MJ
Estruch Pérez
J
J
Balaguer Doménech
L
L
Gallen Martín
M J
MJ
Hernández Cádiz
C
C
Solaz Roldán
D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000295:instrumentation / Q000379:methods; D001786:Blood Glucose / Q000032:analysis; D002045:Bupivacaine / Q000008:administration & dosage*; D057785:Catheters; D004388:Dura Mater / Q000293:injuries; D004824:Epidural Space; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D011312:Pressure; D011446:Prospective Studies; D011677:Punctures
D001786:Blood Glucose; D005947:Glucose; D002045:Bupivacaine