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

Siddik-Sayyid, Sahar M.; Taha, Samar K.; Aouad, Marie T.; Daaboul, Dima G.; Deeb, Patricia G.; Khatib, Mohamed F. El; Baraka, Anis

doi:10.1016/j.jclinane.2006.03.015

Cited by 12 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our administration of local anesthetic solution prior to catheter insertion lubricated the epidural space, reduced the friction between the catheter and the nerves behind the dura, blocked the cauda equina, and equally lowered the incidence of paresthesia in both groups without a significant difference. 28 The addition of 5 lg/mL epinephrine to ropivacaine epidural anesthesia appeared to be safe for both the neonate and mother. It did not increase the incidence of maternal hypotension or affect FHR, as previously demonstrated.…”

Section: Discussionmentioning

confidence: 95%

Epinephrine adjuvant reduced epidural blood vessel penetration incidence in a randomized, double‐blinded trial

Denny

Cohen

Stein

et al. 2015

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 95%

Epinephrine adjuvant reduced epidural blood vessel penetration incidence in a randomized, double‐blinded trial

Denny

Cohen

Stein

et al. 2015

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…[ 11 ] Saline pre-distension of epidural space with 2 ml versus 10 ml prior to test dose has reported wider dermatomal block in parturients. [ 12 ] However, our study population included only non-pregnant patients. A time period of 6 min is required to detect motor blockade due to accidental intrathecal placement with 60 mg lignocaine.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of segmental epidural blockade following standard test dose versus test dose with addition of saline in abdominal surgeries

et al. 2020

View full text Add to dashboard Cite

Background and Aims: Epidural analgesia is widely used for pain relief but confirmation of accurate epidural placement is poorly understood. We proposed that sensory blockade to cold sensation would predict the accurate placement of epidural. The primary outcome was the assessment of sensory blockade at 5 and 10 min with a standard epidural test dose versus test dose with additional saline. We looked at haemodynamic changes following administration as secondary outcomes. Methods: Following Ethics Committee approval, 161 patients presenting for elective abdominal surgery needing epidural analgesia with general anaesthesia were randomly allocated into Group 1 receiving standard test dose (3 ml of 2% lignocaine with 1:2,00,000 adrenaline) or Group 2 (standard test dose with 6 ml of saline) epidurally. The blockade to cold sensation was assessed at 5 and 10 min. The heart rate (HR), systolic blood pressure (SBP), and mean arterial pressure (MAP) were recorded at baseline, 1, 5, and 10 min following epidural dosing. Statistical analysis was performed with Chi-square test for categorical and Student's t -test for continuous variables. Results: The sensory blockade at 5 min was 69.5% versus 82.3% ( P = 0.059), and at 10 min 85.4% versus 97.5% ( P = 0.01) in Groups 1 and 2, respectively. The MAP at 5 min ( P = 0.032) and the HR and MAP at 10 min ( P = 0.015, 0.04) were significantly lower in Group 2. Conclusion: An epidural test dose of 3 ml followed by additional 6 ml saline accurately predicted sensory blockade to cold at 10 min in comparison to the standard dose of 3 ml but was associated with a decrease in the HR and MAP.

show abstract

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Azam¹,

Akthar²,

Butt³

2016

Annals KEMU

View full text Add to dashboard Cite

Objective:The objective of this study was to determine if injecting 10 ml saline in epidural space before epidural catheter placement in pregnant women undergoing cesarean section can decrease the frequency of inadvertent intravascular catheter placement.Study Design:Randomize Controlled Trail.Place and Duration of Study:Department of Anaesthesia at Gynaecology and Obstetrics operation theater, Jinnah Hospital, Lahore affiliated with College of Physician and Surgeon Pakistan from April 2008 to March 2009.Methodology:Sixty pregnant patients (ASA I and II) randomly allocated in Group A and B equally for elec-tive cesarean section were selected. In each patient epidural space was identified with LOR technique using air in sitting position. In Group A (dry group), no saline was injected while in Group B (saline gro-up), 10 ml saline was injected before epidural catheter placement. Using 16 G Toughy needle, catheter was inserted up to 4 cm in the epidural space. To find out inadvertent intravascular catheter placement, epidural catheter was aspirated to exclude blood. After negative aspiration, test dose of 3ml injection xylocain 2% (with adrenaline 1:200,000) was administrated and patient were monitored one minute for increase in heart rate (> 20% of baseline), tinnitus and perioral numbness.Results:In both group data collected was analyzed in SPSS version 11 and Chi-square test was applied. P value of 0.05 or less was taken significant. Percentage of positive inadvertent intravascular catheterization in term of bloody aspirate (20 and 13.3%) was not signi-ficantly different between two groups (P value = 0.488). Increase in heart rate, tinnitus and perioral numbness was not observed in any patient.Conclusion:There was no significant difference in accidental intravascular catheterization if 10 ml saline is injected through needle before catheter insertion.Key word:Epidural catheter, accidental intravascular catheterization, anaesthesia.

show abstract

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

Cited by 12 publications

References 16 publications

Epinephrine adjuvant reduced epidural blood vessel penetration incidence in a randomized, double‐blinded trial

Epinephrine adjuvant reduced epidural blood vessel penetration incidence in a randomized, double‐blinded trial

Evaluation of segmental epidural blockade following standard test dose versus test dose with addition of saline in abdominal surgeries

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

Contact Info

Product

Resources

About