Abstract
Epidural catheter insertion may be associated with blood vessel trauma or nerve root irritation. The purpose of this study was to assess whether the injection of small amounts of fluid through the Tuohy needle prior to catheter insertion reduced the incidence of these and other minor complications. Two hundred patients in labour, requesting epidural analgesia, were randomly assigned to one of three groups: Group I —the catheter was inserted without previous injection of fluid; Group II —3 ml, 1.5 per cent lidocaine hydrochloride was injected through the needle prior to catheter insertion; Group III —3 ml, saline was injected prior to catheter insertion. There were no differences among the groups in the incidence of blood vessel trauma or paraesthesiae. We conclude that there is no advantage in injecting of fluid routinely into the epidural space prior to catheter insertion.
Résumé
Un cathéter qui pénètre dans l’espace épidural peut irriter une racine nerveuse ou transpercer un vaisseau. Nous avons essayé de diminuer l’incidence de ces complications en injectant du liquide dans l’aiguille de Tuohy avant d’y introduire le cathéter. Nous avons randomisé en trois groupes, 200 candidates à l’analgésie épidurale pendant le travail. Dans le groupe I, nous insérions le cathéter sans injection préalable alors que dans les groupes II et III, nous injections respectivement 3 ml de lidocaïne à 1,5 pour cent et 3 ml de soluté physiologique avant de passer le cathéter. Nous n’avons pu démontrer quelque différence que ce soit entre les groupes quant à l’incidence de traumatisme vasculaire ou de paresthésie. Il ne semble donc pas y avoir d’avantage à injecter de liquide dans l’espace épidural avant d’y introduire un cathéter.
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Rolbin, S.H., Halpern, S.H., Braude, B.M. et al. Fluid through the epidural needle does not reduce complications of epidural catheter insertion. Can J Anaesth 37, 337–340 (1990). https://doi.org/10.1007/BF03005586
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DOI: https://doi.org/10.1007/BF03005586