Complications of 761 short-term intrathecal macrocatheters in obstetric patients: a retrospective review of cases over a 12-year period
| Autor: | J.S. Ranasinghe, Daria Moaveni, Jennifer Cohn, J. Sznol |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Anesthesia Epidural medicine.medical_specialty Catheters Adolescent Post-dural-puncture headache Cauda equina syndrome Obstetric anesthesia 03 medical and health sciences 0302 clinical medicine Hematoma Pregnancy 030202 anesthesiology medicine Anesthesia Obstetrical Humans 030212 general & internal medicine Abscess Retrospective Studies Epidural blood patch Cesarean Section business.industry Obstetrics and Gynecology medicine.disease Surgery Anesthesiology and Pain Medicine Anesthesia Female Post-Dural Puncture Headache Arachnoiditis medicine.symptom Respiratory Insufficiency business Meningitis Blood Patch Epidural |
| Zdroj: | International Journal of Obstetric Anesthesia. 25:30-36 |
| ISSN: | 0959-289X |
| DOI: | 10.1016/j.ijoa.2015.08.006 |
| Popis: | Background A continuous spinal catheter is a reliable alternative to standard neuraxial techniques in obstetric anesthesia. Despite the potential advantages of intrathecal catheters, they remain underutilized due to fear of infection, nerve damage or post-dural puncture headache. In our tertiary care center, intrathecal catheters are either placed intentionally in high-risk obstetric patients or following inadvertent dural puncture using a 19-gauge macrocatheter passed through a 17-gauge epidural needle. Methods A retrospective review of 761 intrathecal catheters placed from 2001 to 2012 was conducted. An institutional obstetric anesthesia database was used to identify patients with intrathecal catheters. Medical records were reviewed for procedural details and complications. Results There were no serious complications, including meningitis, epidural or spinal abscess, hematoma, arachnoiditis, or cauda equina syndrome, associated with intrathecal catheters. The failure rates were 2.8% (3/108) for intentional placements and 6.1% (40/653) for placements following accidental dural puncture. The incidence of post-dural puncture headache was 41% (312/761) and the epidural blood patch rate was 31% (97/312). Conclusions This review demonstrates that intrathecal catheters are dependable and an option for labor analgesia and surgical anesthesia for cesarean delivery. Serious long-lasting complications are rare. |
| Databáze: | OpenAIRE |
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