Epidural Catheter Direction and Local Anesthetic Dose

Evaluation of thoracic epidural catheter position and migration using radio‐opaque catheters

“…Other investigators have used radioopaque dye which may cause allergic reactions [5] and possible contamination because of temporary disconnection [1][2][3][5][6][7][8][9][10][11].…”

“…A similar study [7] showed 48% cephalad, 9% caudal and 43% neutrally positioned catheters compared to the insertion level. Another group [3] reported 32% caudal and 68% cephalad directed lumbar epidural catheters and showed that more local anaesthetic is necessary to achieve a given sensory level of block if the catheter moves caudally instead of cephalad. A possible explanation for the small percentage of cephalad directed catheters in our study may be the smaller volume of the thoracic epidural space compared to that of the lumbar space [12].…”

“…The effectiveness of epidural anaesthesia is influenced by the level of epidural catheter insertion and the catheter tip position [1][2][3]. It is advisable to insert the catheter proximal to the segments to be treated [2,4].…”

“…Three methods for evaluation of the catheter position in the epidural space have been described. These techniques either require radio-opaque dye [1][2][3][5][6][7] or are indirect [5]. We evaluated the visibility and migration of catheter position at the high thoracic level using a radio-opaque epidural catheter and postoperative chest radiography.…”

Evaluation of thoracic epidural catheter position and migration using radio-opaque catheters

“…position [1][2][3]. It is advisable to insert the catheter proximal to the segments to be treated [2, 4|.…”