Soft catheters reduce the risk of intravascular cannulation during epidural block--a retrospective analysis of 1,117 cases in a medical center.
A wet or bloody tap is an inevitable complication while performing epidural block. The influence of different catheters on the incidence of intravascular cannulation during epidural catheterization has not been reported. We observed an initial, relatively different incidence of intravascular cannulation during the placement of different sorts of epidural catheter; hence, a retrospective review was conducted to explore the possible association. We reviewed 1-year interval anesthetic records of 1117 patients who had undergone epidural anesthesia or received patient-controlled epidural analgesia. Epidural catheter placement was performed by a loss of resistance technique with an 18-G Tuohy needle in lateral position. Patients were divided into two groups according to the different types of epidural catheters used (Perifix One, n=590; Perifix Standard, n=527). Primary outcome measurement was the incidence of intravascular injection. Other analyzed outcomes included dura puncture, failure rate, and low back pain. The incidence of epiduralintravascular cannulation was significantly lower using the Perifix One catheter (1.5%; 9/590) than using the Perifix Standard (4.6%; 24/527), p=0.003. The dura puncture rate did not differ significantly between the Perifix One (1.9%; 11/590) and the Perifix Standard (2.5%; 13/527), p=0.49. Failure rates and low back pain incidence were also comparable between the two groups. Application of the soft epidural catheter (Perifix One) may reduce the incidence of epidural intravascular cannulation. We suggest the use of Perifix One catheter instead of Perifix Standard catheter in daily practice.
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Chih-Kai
CK
Shih
Fu-Yuan
FY
Wang
Chia-Fang
CF
Shieh
Jui-Mei
JM
Huang
I-Cheng
IC
Lu
Li-Chen
LC
Wu
David Vi
DV
Lu
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D000767:Anesthesia, Epidural / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D057785:Catheters; D004824:Epidural Space / Q000098:blood supply; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D057772:Vascular System Injuries / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult