Does epinephrine improve the diagnostic accuracy of aspiration during labor epidural analgesia?

Unlabelled: Aspiration reliably detects almost all IV multiorifice epidural catheters. Although a supplemental epinephrine 15-microg test dose may detect the rare IV catheter that does not yield blood on aspiration, false-positive epinephrine responses may cause some women to unnecessarily undergo repeat epidural catheter insertion. We evaluated 532 consecutive eligible patients requesting neuraxial labor analgesia.

Labor epidural analgesia without an intravascular "test dose".

Background: This study prospectively evaluated the ability of aspiration to detect intravascular placement of multiple-orifice epidural catheters.

Methods: Multiple-orifice, 20-gauge epidural catheters were inserted in 1,029 laboring women. Catheters were observed and aspirated for blood or cerebrospinal fluid before they were tested with 2 ml local anesthetic.