Evaluation of two different epidural catheters in clinical practice. narrowing down the incidence of paresthesia!
Bouman, E.A.C.; Gramke, H.F.; Wetzel, N.; Vanderbroeck, T.H.T.; Bruinsma, R.; Theunissen, M.; Kerkkamp, H.E.M.; Marcus, M.A.E.
Acta Anaesthesiologica Belgica 58(2): 101-105
2007
ISSN/ISBN: 0001-5164 PMID: 17710897 Document Number: 609831
Although epidural anesthesia is considered safe, several complications may occur during puncture and insertion of a catheter. Incidences of paresthesia vary between 0.2 and 56%. A prospective, open, cohort-controlled pilot study was conducted in 188 patients, ASA I-III, age 19-87 years, scheduled for elective surgery and epidural anesthesia. We evaluated a 20 G polyamide (standard) catheter and a 20 G combined polyurethane-polyamide (new) catheter. Spontaneous reactions upon catheter-insertion, paresthesia on questioning, inadvertent dural or intravascular puncture, and reasons for early catheter removal were recorded. The incidence of paresthesia reported spontaneously was 21.3% with the standard catheter and 16.7% with the new catheter. Systematically asking for paresthesia almost doubled the paraesthesia rate. Intravascular cannulation occurred in 5%. No accidental dural punctures occurred. An overall incidence of 13.3% of technical problems led to early catheter removal. The new catheter was at least equivalent to the standard regarding epidural success rate and safety : rate of paresthesia, intravascular and dural cannulation.