Effects of Predistention with Normal Saline Containing Adrenaline on Blood-Vessel Injury during Epidural Catheter Placement

Abstract

This study investigated the effects of predistention with normal saline containing adrenaline on vascular plexus injury during epidural catheter placement. Three hundred parturients undergoing caesarean sections were randomly divided into three groups. Group I (n = 102) received an epidural injection with 5 ml normal saline; group II (n = 93) received 5 ml normal saline containing adrenaline (5 µg/ml); group III (n = 100) received direct epidural catheter placement. Five women were excluded from the analysis for technical reasons. There were no significant differences in the incidence of bloody fluid in the epidural catheter or in the incidence of intravascular epidural catheter placement between the three groups. Predistention with 5 ml normal saline before catheter insertion reduced the incidence of blood-vessel injury during epidural catheter placement, but adrenaline provided no additional protective effects.

Administration of Saline Injection in Epidural Space Avoids Intravascular Catheter Insertion in Patients Undergoing Caesarian Section: A Randomize Controlled Trial

“…There were no significant differences in the incidence of bloody fluid in the epidural catheter or in the incidence of intravascular epidural catheter placement between the three groups. 7 The result of our study are supported by Saddik Sayyed et al who could not find significant difference between blood vessel trauma by 2 ml and 10 ml injection of saline prior to epidural catheter insertion in parturient. 8 However a large number of studies showed significant decrease in accidental intravascular catheterization with saline predistention in epidural space before catheter placement.…”

“…Different research workers used different methods to expand the epidural space and thus to prevent inadvertent intravascular catheterization. [5][6][7][8][9][10][11][12] The rationale of our study was to see if injecting 10 ml saline decreased the incidence of inadvertent intravascular catheterization.…”

Effects of epinephrine in the epidural space on the incidence of blood vessel injury by epidural catheter insertion for cesarean section: a prospective, randomized, double-blind study

“…The appearance of bloody fluid immediately after catheter placement suggests that epidural blood vessels are injured [13]. Bloody fluid in the epidural needle suggests that the injured veins are close to the epidural needle; however, bloody fluid in the epidural catheter indicated that the injured veins are situated a little further from the epidural needle.…”