Purpose: To determine if injecting 10 mL saline before epidural catheter threading (pre-cannulation epidural fluid injection) can decrease the incidence of iv epidural catheter placement during combined spinal-epidural (CSE) labour analgesia.
Methods: One hundred healthy women requesting CSE labour analgesia with either fentanyl 20 microg or sufentanil 10 microg were prospectively randomized to receive either no epidural injection (dry group, n = 50) or epidural 10 mL saline injection (saline group, n = 50) before epidural catheter placement. A nylon multiport catheter was then threaded 3-5 cm into the epidural space and the needle was removed. We diagnosed iv catheter placement if blood was freely aspirated, if the mother became tachycardic after injection of epinephrine 15 microg, or if intracardiac air was heard (using ultrasound) after injection of air 1.5 mL.
Results: Intravenous epidural catheter placement occurred in one saline and ten dry group patients (P < 0.01). No complications of excessive cephalad intrathecal opioid spread (i.e., difficulty swallowing, hypoxemia, or respiratory arrest) occurred.
Conclusions: Injecting 10 mL or saline through the epidural needle after intrathecal opioid injection and before threading the catheter significantly decreased accidental venous catheter placement without any apparent increase in complications from excessive cephalad intrathecal opioid spread.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/BF03021036 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Risk profiles of common brachial plexus block sites: results from the net-ra registry.
Reg Anesth Pain Med
December 2024
Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany.
Introduction: Regional anesthesia is frequently used for upper limb surgeries and postoperative pain control. Different approaches to brachial plexus blocks are similarly effective but may differ in the frequency and severity of iatrogenesis. We, therefore, examined large-scale registry data to explore the risks of typical complications among different brachial plexus block sites for regional anesthesia.
View Article and Find Full Text PDFElimination of High-grade Gliomas Through Induced Cytolysis, Elucidated by Two Patient Cases.
Anticancer Res
January 2025
Department of Medical Sciences, Clinical Chemistry, University of Uppsala, Uppsala, Sweden
Background/aim: Glioblastoma multiforme (GBM) is the most common and aggressive form of primary malignant tumors in the central nervous system of adults. In practice, all patients with GBM experience relapse, and treatment options become limited following first-line therapy. We previously reported a new, successful treatment approach for a GBM patient, implemented in direct conjunction with surgical intervention.
View Article and Find Full Text PDFEarly postoperative lumbar catheter severing in a lumboperitoneal shunt due to bite-off by the spinous processes following a fall on the buttocks: illustrative case.
J Neurosurg Case Lessons
December 2024
Department of Neurosurgery, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan.
Background: Rupture of the lumbar catheter in lumboperitoneal (LP) shunts is rare and typically occurs due to long-term mechanical stress. The authors describe an unusual case of early postoperative lumbar catheter severing after a fall on the buttocks.
Observations: A 78-year-old woman underwent LP shunt placement for communicating hydrocephalus after aneurysmal subarachnoid hemorrhage.
Preclinical Experience Using 4D Intracardiac Echocardiography to Guide Cardiac Electrophysiology Procedures.
J Cardiovasc Electrophysiol
December 2024
Division of Cardiovascular Medicine, Cardiac Electrophysiology Section, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Introduction: Intracardiac echocardiography (ICE) is an essential imaging modality for electrophysiology procedures, allowing intraprocedural monitoring, real-time catheter manipulation guidance, and visualization of complex anatomic structures. Four-dimentional (4D) ICE is the next stage in the evolution of the technology, permitting 360° rotation of the imaging plane, simultaneous multiplanar imaging, and volumetric acquisition, similar to transesophageal echocardiography (TEE). In this study, we report our experience with a novel 4D ICE catheter (NuVision, Biosense Webster) in structural electrophysiology procedures and difficult ventricular ablations in a swine preclinical model.
View Article and Find Full Text PDFNo Right Way: Removal of a Pencil Foreign Body From a Male Urethra.
Cureus
November 2024
Urology, Sunderland Royal Hospital, Sunderland, GBR.
Foreign body insertion into the urethra is uncommonly encountered in urology practice. Such insertion can result in a myriad of problems including bleeding, infectious sequelae, urinary retention, urethral injury or rupture, and resultant urethral stricture formation. This article describes a case in which an elderly male inserted a pencil into his urethra, which subsequently became lodged and required removal under regional anesthesia in the operating theater.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!