Epidural needle insertion : A large registry analysis
| Autor: | A. Huth, Antje Gottschalk, Alexander Raddatz, J. Winckelmann, Thea Koch, J. Döffert, O. Vicent, Winfried Meissner, Bernd Kutter, Thomas Wiesmann, Hinnerk Wulf, Thomas Standl, Jürgen Birnbaum, N. Paquet, S. Liebl-Biereige, Stefan Wagenpfeil, Daniel I. Sessler, Thomas Volk, Hartmut Bürkle, Hagen Bomberg, Paul Kessler, W. Hering |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Anesthesia Epidural Male medicine.medical_specialty Punctures Catheterization 03 medical and health sciences 0302 clinical medicine Lumbar 030202 anesthesiology Risk Factors Anesthesiology medicine Anesthesia Obstetrical Humans Risk factor Aged business.industry 030208 emergency & critical care medicine General Medicine Odds ratio Middle Aged Confidence interval Surgery Anesthesiology and Pain Medicine Needles Needle insertion Female business Complication Body mass index |
| Zdroj: | Der Anaesthesist. 67(12) |
| ISSN: | 1432-055X |
| Popis: | Dural puncture, paraesthesia and vascular puncture are the most common complications of epidural catheter insertion. Their association with variation in midline needle insertion depth is unknown. This study evaluated the risk of dural and vascular punctures and the unwanted events paraesthesia and multiple skin punctures related to midline needle insertion depth. A total of 14,503 epidural catheter insertions including lumbar (L1–L5; n = 5367), low thoracic (T7–T12, n = 8234) and upper thoracic (T1–T6, n = 902) insertions, were extracted from the German Network for Regional Anaesthesia registry between 2007 and 2015. The primary outcomes were compared with logistic regression and adjusted (adj) for confounders to determine the risk of complications/events. Results are presented as odds ratios (OR, [95% confidence interval]). Midline insertion depth depended on body mass index, sex, and spinal level. After adjusting for confounders increased puncture depth (cm) remained an independent risk factor for vascular puncture (adjOR 1.27 [1.09–1.47], p = 0.002) and multiple skin punctures (adjOR 1.25 [1.21–1.29], p |
| Databáze: | OpenAIRE |
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