A Comparison of Espocan® and Tuohy Needles for the Combined Spinal-Epidural Technique for Labor Analgesia
| Autor: | David A O'Gorman, Ingrid M. Browne, David J. Birnbach, D. J. Stein, Maxine M. Kuroda |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Epidural needles Intrathecal Anesthesia Spinal Catheterization Cerebrospinal fluid Heart Rate Pregnancy Humans Medicine Labor analgesia Paresthesia Cerebrospinal Fluid Pain Measurement Spinal instrumentation business.industry Heart Rate Fetal Middle Aged Surgery Analgesia Epidural Catheter Anesthesiology and Pain Medicine Combined spinal epidural Needles Anesthesia Costs and Cost Analysis Analgesia Obstetrical Female business |
| Zdroj: | Anesthesia & Analgesia. 101:535-540 |
| ISSN: | 0003-2999 |
| DOI: | 10.1213/01.ane.0000157162.41892.6a |
| Popis: | When using the needle-through-needle combined spinal-epidural (CSE) technique for labor analgesia, failure to obtain cerebrospinal fluid (CSF), paresthesias, and intrathecal or intravascular migration of the catheter are of concern. Epidural needles with spinal needle apertures, such as the back-hole Espocan (ES) needles, are available and may reduce these risks. We describe the efficacy and adverse events associated with a modified epidural needle (ES) versus a conventional Tuohy needle for CSE. One-hundred parturients requesting labor analgesia (CSE) were randomized into 2 groups: 50-ES 18-gauge modified epidural needle with 27-gauge Pencan atraumatic spinal needle, 50-conventional 18-gauge Tuohy needle with 27-gauge Gertie Marx atraumatic spinal needle. Information on intrathecal or intravascular catheter placement, paresthesia on introduction of spinal needle, failure to obtain CSF through the spinal needle after placement of epidural needle, unintentional dural puncture, and epidural catheter function was obtained. No intrathecal catheter placement occurred in either group. Rates of intravascular catheter placement and unintentional dural puncture were similar between the groups. Significant differences were noted regarding spinal needle-induced paresthesia (14% ES versus 42% Tuohy needles, P = 0.009) and failure to obtain CSF on first attempt (8% ES versus 28% Tuohy needles, P0.02). Use of ES needles for CSE significantly reduces paresthesia associated with the insertion of the spinal needle and is associated with more frequent successful spinal needle placement on the first attempt.The use of modified epidural needles with a back hole for combined spinal-epidural technique significantly reduces paresthesia associated with the insertion of the spinal needle and is associated with more frequent successful spinal needle placement on the first attempt. |
| Databáze: | OpenAIRE |
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