Ziauddin Ahmed, Muhammad Abdul Aziz, Rabia Waheed, Yaasir Ijaz, Abdul Shakoor, Saad Ishtiaq.
Frequency of I/V Placement of Epidural Catheter with/ Without Predistension of Epidural Space with saline.
Pak J Med Health Sci Jan ;13(2):339-41.

Background: Epidural anesthesia is a popular technique because of advantages like slower onset of action, controlled hypotension, usefulness in thoracic, abdominal and lower limb surgeries and also for the management of postoperative analgesia in lower abdominal surgeries. But it has several complications like intravascular catheter placement, intrathecal catheter placement and local anesthesia toxicity. Aim : To compare the frequency of intravascular catheter placement with pre-distention and without pre-distention of epidural space with saline. Study design : Randomized controlled trial . Setting: Department of Anesthesia, SKMCH and RC, Lahore . Duration of study: Six months . Data Collection Technique : 140 patients taken from elective general surgical list were included in this study. Epidural was placed with Tuohy needle in sitting position using midline approach. In Group A (distention group). In Group B (non-distention group). The epidural needle was then removed and the catheter withdrawn to leave 5 cm catheter in the space. The catheter was then fixed on the patient’s back. Results: In distention group mean age was 46.87 +/- 8.87 years and in non-distention group mean age of patient was 46.01+/-9.52 year s. In distention group there were 29 (41.4%) male and 19 (27.1%) female patients and in non-distention group there were 41(58.6%) male and 51(72.9%) female’s patients. In all patient’s intravascular placement of epidural catheter was observed in 18 (12.9% ) of the patients. In which 3 (4.3%) patients were in distention group and 15 (21.4%) were in non-distention group. Intravascular placement of epidural catheter was statistically lower in group A as compared to group B, p-value = 0.002 (< 0.05).Conclusion : Intravascular catheter placement can be minimized with pre-distention with 5ml saline if injected through the epidural needle followed by insertion of the catheter threading it > 5 cm into the epidural space via needle.

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