PMID: 16527791Mar 11, 2006Paper

High quality labour analgesia using small gauge epidural needles and catheters

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Pamela AngleAlexander Kiss

Abstract

Inadvertent epidural needle punctures represent the leading cause of severe postdural puncture headache (PDPH) in parturients. Use of small gauge (G) epidural needles for continuous analgesia has received little attention despite possible important reductions in PDPH. We report the first study to examine the feasibility of using small G Tuohy needles and 23 G catheters for labour analgesia. Healthy parturients <or= 6 cm dilated were recruited. Epidural analgesia was established using a 19 G Tuohy epidural needle, a 23 G single port 40 cm catheter and bupivacaine 0.08% with fentanyl 2 microg x mL(-1) (15-20 mL). Breakthrough pain was treated by protocol. There was no formal in-training period for anesthesiologists. The primary outcome was the combined failure rate for initiation (failed needle/catheter placement or failed block <or= 30 min of drug administration). Secondary out-comes included late block failure (> 30 min), recognized dural puncture, PDPH, patient assessment of analgesia within 24 hr of delivery, complications and anesthesiologist satisfaction. Twenty-seven parturients were recruited. Successful blocks were initiated and maintained in 24/27 who rated overall analgesia from good to excellent (19/24 very good to ex...Continue Reading

Associated Clinical Trials

References

Dec 1, 1994·Anesthesiology·S Halpern, R Preston
Mar 15, 1994·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·E Crosby
Sep 18, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·P AngleD B Wilson
Aug 24, 2004·International Journal of Obstetric Anesthesia·M PaechL Gurrin
Apr 9, 2005·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Pamela AngleJohn Paul Szalai

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Citations

Dec 7, 2010·International Journal of Obstetric Anesthesia·A DoyleJ Carter
Jun 24, 2015·BMC Anesthesiology·Huanwei JiangShiyuan Xu
May 7, 2008·Current Opinion in Anaesthesiology·Melanie Thew, Michael J Paech

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