The Placement of the Epidural Catheter at the Predicted Site by Electrical Stimulation Test

Autor: Tomohiro Yamakura, Hiroshi Baba, Hideyoshi Fujihara, Keiko Hayatsu, Misao Tomita, Koki Shimoji, Kiichiro Taga
Rok vydání: 2001
Předmět:
Zdroj: Anesthesia & Analgesia. 93:1035-1039
ISSN: 0003-2999
DOI: 10.1097/00000539-200110000-00048
Popis: UNLABELLED More accurate segmental and sagittal positioning of the epidural catheter tip is required for the success of continuous epidural analgesia, spinal cord monitoring, and percutaneous epidural spinal cord stimulation. We examined the usefulness of an electrical stimulation test for verifying the proper placement of the epidural catheter tip at the predicted site in the posterior epidural space by using a locally developed epidural catheter with electrodes at its tip. The test included the observation of segmental bilateral muscle twitches and the patient's report of feeling in the region stimulated by moving the epidural catheter electrode back and forth and changing the direction of the bevel of the Tuohy needle. The success rate of midline placement at the required spinal segment was significantly more frequent (99%; P < 0.001) in the group (n = 289) receiving the electrical stimulation test compared with the group (n = 277) not receiving the test (success rate 57%). The results indicate the usefulness of this method. We concluded that the electrical stimulation test is effective for verifying the proper placement of the catheter electrode tip. IMPLICATIONS Ideally the epidural catheter tip should be positioned in the posterior epidural space near the midline. We concluded that the electrical stimulation test is effective for verifying the proper placement of the catheter electrode tip.
Databáze: OpenAIRE