Are combined spinal-epidural catheters reliable?

Autor: Mark C. Norris
Rok vydání: 2000
Předmět:
Zdroj: International Journal of Obstetric Anesthesia. 9:3-6
ISSN: 0959-289X
DOI: 10.1054/ijoa.1999.0301
Popis: SUMMARY. The combined spinal-epidural (CSE) technique can rapidly relieve labor pain. However, the location of the epidural catheter is initially uncertain. In an emergency, this untested catheter may fail to provide adequate anesthesia. This study compared the efficacy of catheters placed as a part of an epidural or needle-through-needle CSE technique in laboring women. Patients requesting pain relief received either epidural (n=601) or CSE (n=1061) analgesia. All patients had a 20 gauge, closed tip multi-holed polyamide catheter (B. Braun Medical, Inc.) inserted 2‐8 cm into the epidural space. Catheters were tested to rule out intrathecal and intravascular location. Then, epidural patients received 10‐20 mL local anesthetic ∠ opioid in divided doses. CSE patients received an infusion of 0.083% bupivacaine with opioid at 10‐15 mL/h. Of the 1495 catheters that were adequately tested, those inserted as part of a CSE technique were more likely to produce bilateral sensory change and adequate analgesia than were those inserted without prior spinal analgesia (98.6% vs 98.2%, P
Databáze: OpenAIRE