Continuous amnioinfusion via an epidural catheter following spontaneous membrane rupture: A case report

Turgut, Abdülkadir; Katar, Selahattin; Sak, Muhammet Erdal; Turgut, Fethiye Gülden; Şahin, Alparslan; Başaranoğlu, Serdar; Yalinkaya, Ahmet

doi:10.5152/jtgga.2013.53367

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…Epidural catheters are even used during the infusion of cryoprecipitate and platelets into the amniotic cavity to treat premature rupture of fetal membrane and oligohydramnios in pregnant women ( 22 , 23 ). This approach provides a new perspective on the use of epidural catheters, prompting clinicians to understand the application and clinical value of epidural catheters and better use this clinical device ( 23 – 25 ). An endoscopic approach make sense because it would minimize the postoperative risk of CSF leak and intracranial hypotension than might result from incidental dural tears.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous fully endoscopic surgical management of the ruptured epidural catheter: Rescue of the novice anesthesiologist from his dilemma

Kong

Du²,

Xin³

et al. 2022

Front. Surg.

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BackgroundEpidural nerve block and analgesia are basic anesthetic techniques for anesthesia. Epidural catheter rupture and partial retention are adverse events and rare complications of epidural catheterization technique. The probability of occurrence when applied by novice doctors is high. Removal of the residual catheter by conventional surgery causes more trauma and bleeding, slows recovery, and may causes medical disputes. We hypothesized that percutaneous spinal endoscopy a safe and effective remediation technique. This study was to analyze the efficacy and safety of removing the residual dural catheter by a percutaneous full-endoscopic technique(PFET) and discuss the clinical technique and precautions.MethodsThis was a retrospective analysis of 7 patients with ruptured epidural catheters treated in our department from October 2015 to October 2019 using the PFET to remove the remaining epidural catheter. The operation time, intraoperative bleeding volume, surgical complications, and neurological symptoms before and after surgery were recorded. The Self-Rating Anxiety Scale (SAS) was used to assess the anxiety level of the anesthesiologist and the patient before and after the catheter removal operation, and the postoperative low back pain VAS score was recorded.ResultsThe remaining epidural catheter was successfully removed from all 7 patients. The operation time was 54.14 ± 14.45 (32–78) minutes, and the intraoperative blood loss was 9.134 ± 3.078 (5–15) ml. There were no cases of dural damage, cerebrospinal fluid leakage, sensorimotor dysfunction of the lower limbs, or bowel dysfunction. The anxiety symptoms of the patient and the anesthesiologist disappeared after removal of the residual epidural catheter. The patients' postoperative back pain VAS score was 0 to 2 points.ConclusionPFET is a safe and effective minimally invasive technique for removing residual epidural catheters. It causes less trauma and less bleeding, allows a faster recovery. It does not affect the recovery of patients from other surgical operations and reduces both medical risks and medical costs. At the same time, it avoids or reduces the occurrence of medical disputes and eliminates the pressure on novice anesthesiologists regarding similar adverse events.

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Section: Discussionmentioning

confidence: 99%

Percutaneous fully endoscopic surgical management of the ruptured epidural catheter: Rescue of the novice anesthesiologist from his dilemma

Kong

Du²,

Xin³

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…Epidural catheters are even used during the infusion of cryoprecipitate and platelets into the amniotic cavity to treat premature rupture of fetal membrane and oligohydramnios in pregnant women [21,22]. This approach provides a new perspective on the use of epidural catheters, prompting clinicians to understand the application and clinical value of epidural catheters and better use this clinical device [22,23,24].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous fully endoscopic surgical management of the ruptured epidural catheter: Rescue of the young anesthesiologist from his dilemma

Kong¹,

Cao²,

Liu³

et al. 2020

Preprint

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Background Epidural nerve block and analgesia are basic operation techniques for anesthesia. Epidural catheter rupture and partial retention are adverse events and rare complications of epidural catheterization technology. The probability of occurrence when applied by young doctors is high. Removal of the residual catheter by conventional surgery causes more trauma and bleeding, slows recovery, and causes medical disputes. These events also challenge the growth of young doctors. Some hospitals have almost eliminated this operation technique. All surgical patients undergo intubation and general anesthesia, which greatly wastes medical resources and increases patient costs. Objective To analyze the efficacy and safety of removing the residual dural catheter by a percutaneous endoscopic technique and discuss the clinical technique and precautions. Methods This was a retrospective analysis of 7 patients with ruptured epidural catheters treated in our department from October 2015 to October 2019 using the percutaneous spinal endoscopic technique to remove the remaining epidural catheter. The operation time, intraoperative bleeding volume, surgical complications, and neurological symptoms before and after surgery were recorded. The Self-Rating Anxiety Scale (SAS) was used to assess the anxiety level of the anesthesiologist and the patient before and after the catheter removal operation, and the postoperative low back pain VAS score was recorded. Results The remaining epidural catheter was successfully removed from all 7 patients. The operation time was 54.14 ± 14.45 (32–78) minutes, and the intraoperative blood loss was 9.134 ± 3.078 (5–15) ml. There were no cases of dural damage, cerebrospinal fluid leakage, sensorimotor dysfunction of the lower limbs, or bowel dysfunction. The anxiety symptoms of the patient and the anesthesiologist disappeared after removal of the residual epidural catheter. The patients' postoperative back pain VAS score was 0 to 2 points. Conclusion Percutaneous spinal endoscopy is a safe and effective minimally invasive technique for removing residual epidural catheters. It causes less trauma and less bleeding, allows a faster recovery, and has a low cost. It does not affect the recovery of patients from other surgical operations and reduces both medical risks and medical costs. At the same time, it avoids or reduces the occurrence of medical disputes and eliminates the pressure on young anesthesiologists regarding similar adverse events.

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“…In studies in PPROM this approach was found to be insufficient (68) and continuous amnioinfusion therapies were developed for this patient group. There have been reports of implantation of a subcutaneous port with an intraamniotic catheter to infuse fluid (69) or use of an indwelling epidural catheter in the amniotic space (70) in patients with PPROM. The use of a subcutaneous amniotic port (amnioport) has also been studied in EPRA patients with promising outcomes (71).…”

Section: Innovations In Renal Diseasementioning

confidence: 99%

Fetal interventions for congenital renal anomalies

Irfan¹,

O’Hare²,

Jelin³

2021

Transl Pediatr

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Congenital abnormalities of the kidney and urinary tract (CAKUT) represent 20% of prenatally diagnosed congenital abnormalities. Although the majority of these abnormalities do not require intervention either pre or postnatally, there is a subset of patients whose disease is so severe that it may warrant intervention prior to delivery to prevent morbidity and mortality. These cases consist of patients with moderate lower urinary tract obstruction (LUTO) in which vesicocentesis, shunting or cystoscopy are options and patients with early pregnancy renal anhydramnios (EPRA) in whom amnioinfusion therapy may be an option. The main causes of EPRA are congenital bilateral renal agenesis (CoBRA), cystic kidney disease (CKD) and severe LUTO. Untreated, EPRA is universally fatal secondary to anhydramnios induced pulmonary hypoplasia. The evidence regarding therapy for LUTO is limited and the stopped early PLUTO (Percutaneous Shunting in Lower Urinary Tract Obstruction) trial was unable to provide definitive answers about patient selection. Evidence for EPRA therapy is also scant. Serial amnioinfusions have shown promise in cases of EPRA due to CoBRA or renal failure and this treatment modality forms the basis of the ongoing NIH funded RAFT (Renal Anhydramnios Fetal Therapy) trial. At present, there is consensus that treatment for EPRA should only occur in the setting of a clinical trial.

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Continuous amnioinfusion via an epidural catheter following spontaneous membrane rupture: A case report

Cited by 6 publications

References 12 publications

Percutaneous fully endoscopic surgical management of the ruptured epidural catheter: Rescue of the novice anesthesiologist from his dilemma

Percutaneous fully endoscopic surgical management of the ruptured epidural catheter: Rescue of the novice anesthesiologist from his dilemma

Percutaneous fully endoscopic surgical management of the ruptured epidural catheter: Rescue of the young anesthesiologist from his dilemma

Fetal interventions for congenital renal anomalies

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