경막외강 카테터 삽입 시 삽입 길이와 감각이상의 빈도
Incidence of Paresthesia Related to the Insertion Length of Catheter during the Epidural Catheterization
2
조회
0
다운로드
0
인용
0
참고문헌
초록
Abstract
Background: Continuous epidural catheterization is a popular and effective procedure for postoperative analgesia. However, continuous epidural catheterization has associated complications such as venous puncture, dural puncture, subarachnoid cannulation, suboptimal catheter placement, and paresthesia because the tip of the epidural catheter touches thenerves of the dura in the epidural space. In this study, we compared the incidence of paresthesia in two different lengths of epidural catheter insertion. Methods: One hundred women undergoing gynecologic or orthopedic surgery were enrolled in this prospective, double-blinded, randomized study. All patients were randomly divided into two groups based on the insertion length of the epidural catheter 2 cm (group A) or 4 cm (group B). A Tuohy needle was inserted in the lumbarspinal region with a bevel directed cephalad by use of the median approach, and then the epidural space was confirmed by the loss of resistance technique with air. While the practitioner inserted an epidural catheter into the epidural space, a blind observer checked for paresthesia or withdrawal movement. Results: In 97 included patients, 30.6% of the patients in group A (n = 49) had paresthesia, versus 31.3% in group B (n = 48). Withdrawal movements were represented in 2% and 6% of the patients in group A and group B, respectively. There was no difference in the incidence of paresthesia and withdrawal movement between the two groups. Conclusions: There is no clear relationship for the incidence of catheter-related paresthesia according to the catheter length inserted into the epidural space for epidural analgesia.(Korean J Pain 2007; 20: 50-53)
참고문헌 (16)
- "Spinal, epidural, and caudal anesthesia", pp.1656~1657 (2005), New York, Churchill Livingstone
- "Nerves and nerve plexuses of the human vertebral column", pp.282~96
- "Innervation of the spinal dura. Myth or reality?", 21, pp.18~26 (1996)
- "The innervation of the lumbar spine", pp.286~93
- "Role of the sinu-vertebral nerve in low back pain and anatomical basis of therapeutic implications", 24, pp.366~371 (2003)
- "Direction of catheter insertion and incidence of paresthesias and failure rate in continuous epidural anesthesia: a comparison of cephalad and caudad catheter insertion", pp.331~4
- "Pain during spinal canal puncture and its relationship with ligamentum flavum, dura-mater and posterior longitudinal ligament innervation", 54, pp.872~876 (2004)
- "Epidural misplacement of catheters and mechanisms of unilateral blockade", pp.158~61
- "Lumbar epidural catheter insertion: the midline vs. the paramedian approach", 22, pp.839~842 (2005)
- "Administration of local anesthetic through the epidural needle before catheter insertion improves the quality of anesthesia and reduces catheter-related complications", 101, pp.1501~1505 (2005)
- "The optimal distance that a multiorifice epidural catheter should be threaded into the epidural space", 81, pp.301~304 (1995)
- "Fluid through the epidural needle does not reduce complications of epidural catheter insertion", pp.337~40
- "Advancing an epidural catheter 10 cm then retracting it 5 cm is no more effective than advancing it 5 cm", 17, pp.528~530 (2005)
- "Prospective examination of epidural catheter insertion", 84, pp.88~93 (1996)
- "Epidural analgesia- experience of 5628 patients in a large teaching hospital derived through audit", 4, pp.89~97 (2003)
- "Epidural analgesia- experience of 5628 patients in a large teaching hospital derived through audit", 4, pp.89~97 (2003)