Extradural vein puncture—an avoidable complication

Mannion, D.; Walker, Richard L.; Clayton, Kate

doi:10.1111/j.1365-2044.1991.tb09665.x

Cited by 32 publications

(12 citation statements)

References 8 publications

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“…Injection of fluid through the epidural needle may facilitate insertion of the epidural catheter [8] and decrease the frequency of blood vessel trauma [8][9][10][11]. This technique was first suggested by Bromage [12], and its efficacy was confirmed by Verniquet [9] and Mannion et al [10].…”

Section: Discussionmentioning

confidence: 95%

The effect of injection of two vs 10 mL saline on the subsequent spread and quality of epidural analgesia in parturients

Siddik-Sayyid

Taha

Aouad

et al. 2006

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 95%

The effect of injection of two vs 10 mL saline on the subsequent spread and quality of epidural analgesia in parturients

Siddik-Sayyid

Taha

Aouad

et al. 2006

Journal of Clinical Anesthesia

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“…(5) Gadalla et al (6) Mannion et al, (7) all noted a significant reduction in the incidence of extradural vein cannulation by routinely injecting 10 mL of saline priming fluid into the epidural space before catheter insertion. Saline, however, dilutes the local anesthetic injected; in this study, we therefore administered a single-injection dose of local anesthetic (20mL) as a priming solution as done by Cesur et al (5) This study also demonstrated improved surgical conditions with the administration of a single-injection dose through an epidural needle before epidural catheter placement.…”

Section: Discussionmentioning

confidence: 99%

“…(5)(6)(7) Some studies contradicted, (8,9) but in studies showing a lack of effect, either a small and possibly inadequate volume of local anesthetic or normal saline, which would dilute local anesthetic subsequently injected, was given. The use of a large priming dose of local anesthetic has not been studied.…”

mentioning

confidence: 99%

Comparative Study of Effects of Administration of Local Anaesthetics Through Epidural Needle Before and After Epidural Catheter Insertion

Ramtani¹,

Tarkase²,

Cham³

2015

jemds

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Epidural catheter placement offers flexibility in block management. However, during epidural catheter insertion, complications such as paresthesias, venous and subarachnoid cannulation, suboptimal catheter placement and coiling of catheter can affect the quality of anesthesia. A prospective randomized controlled study was conducted to assess the effect of priming of epidural space with a single-injection dose of local anesthetic solution (10mL 2% lidocaine+ adrenaline and 10ml 0.5% bupivacaine) before catheter insertion. We randomized 100 patients into 2 equal groups and measured the quality of anesthesia and incidence of catheter related complications. METHODS: A group of 100 patients was randomized and divided in two groups. In Group A [needle group] (n _ 50), local anaesthetic solution was administered through epidural needle before epidural catheter insertion. In Group B [catheter group] (n _ 50), the catheter was inserted immediately after identification of the epidural space. Local anesthetic solution was then injected via the catheter. We noted the occurrence of paresthesia, inability to advance the catheter, or IV or subarachnoid catheter placement, number of attempts to insert catheter. Sensory and motor block were assessed 20 min after the injection of local anesthetic solution. Surgery was initiated when adequate sensory loss was confirmed. Infraumbilical, pelvic general surgeries, hysterectomies and lower limb orthopedic surgeries were included in study. RESULTS: All observations were noted and statistical test of significance was applied. In the catheter group, the incidence of paresthesia during catheter placement was 16% compared with 4% in the needle group (x 2 =4.0, P<0.05). Intravascular catheter placement occurred in 8% versus 0% of patients in the catheter and needle groups, respectively (x 2 = 5.34, P<0.05). The number of attempts to pass catheter was more than one in catheter group as compared to needle group. (x 2 =4.33, P<0.05) More patients in the needle group had excellent quality of surgical conditions than the catheter group (94% versus 35%) (x 2 =9.75, P<0.05). CONCLUSION: We conclude that priming of epidural space with a single injection local anaesthetic dose via the epidural needle before catheter placement improves the quality of anesthetic blockade and reduces catheter-related complications.

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“…Although not all investigators have found a difference between the lateral and the sitting position, 1,12 others have found that epidural vein puncture occurs less frequently in the lateral position. 13,14 Although venous puncture may be more common with the sitting position, there are other effective and readily available strategies to prevent venous cannulation including saline distension of the epidural space before threading the catheter, 12 and the use of flexible spiral wound epidural catheters. 15 …”

Section: Incidence Of Epidural Vein Puncturementioning

confidence: 99%

Neuraxial techniques for labor analgesia should be placed in the lateral position

Polley

2008

International Journal of Obstetric Anesthesia

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Extradural vein puncture—an avoidable complication

Cited by 32 publications

References 8 publications

The effect of injection of two vs 10 mL saline on the subsequent spread and quality of epidural analgesia in parturients

The effect of injection of two vs 10 mL saline on the subsequent spread and quality of epidural analgesia in parturients

Comparative Study of Effects of Administration of Local Anaesthetics Through Epidural Needle Before and After Epidural Catheter Insertion

Neuraxial techniques for labor analgesia should be placed in the lateral position

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