Fluid Through the Epidural Needle Does Not Reduce Complications of Epidural Catheter Insertion

Epidural volume extension and low-dose sequential combined spinal-epidural blockade: two ways to reduce spinal dose requirement for caesarean section

“…Epidural studies have shown that the accidental intravenous epidural catheter placement rate decreases significantly after injection of 10 mL of bupivacaine (9% vs. 3%) 57 or saline (16% vs. 0%); 58 but not after injection of saline 3 mL (13% vs. 16%). 59 These findings have also been confirmed using the needle-through-needle CSE technique. Gadalla et al demonstrated a significantly decreased accidental intravenous catheter placement when 10 mL saline was injected via the epidural needle before epidural catheter placement in women having CSE for labour analgesia, without any complications from excessive cephalad intrathecal opioid spread.…”

Commonly Used Versus Less Commonly Used Methods in the Loss of Resistance Technique for Identification of the Epidural Space: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Fourteen studies were excluded, as they were reviews, letters to the editor, or did not address one or more aspects of the research question. A total of eight studies [20,28,[46][47][48][49][50][51] with a total of 1583 participants were deemed eligible for inclusion. No additional eligible studies were identified based on hand-searching of major anesthesia journals or manual review of reference lists of relevant primary studies and systematic reviews (Fig.…”

“…Table 2 describes study characteristics regarding setting, number of participants, mean age, gender, eligibility criteria, and follow-up. All included studies [20,28,[46][47][48][49][50][51] were parallel trials. Three studies [20,47, 48] were conducted largely in Asia (one in Korea, and two in Japan), one in Ireland [46], one in Egypt [50], one in Canada [51], and one in Nigeria [49].…”

“…All included studies [20,28,[46][47][48][49][50][51] were parallel trials. Three studies [20,47, 48] were conducted largely in Asia (one in Korea, and two in Japan), one in Ireland [46], one in Egypt [50], one in Canada [51], and one in Nigeria [49]. Evron et al 2004 did not report the setting of their study [28].…”

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

“…Previous studies have also reported a high incidence of paresthesia (N50%) whether local anesthetic or saline was injected into the epidural space before catheter insertion [13,14]. A decrease in the incidence of paresthesia has been only demonstrated with the use of a paramedian technique [15,16], or with the use of soft polyurethane catheters [17].…”