This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Purdie, N. L Articles by Angle, P. J Search for Related Content PubMed Articles by Purdie, N. L Articles by Angle, P. J

IN VITRO VALIDATION OF 23G EPIDURAL CATHETER PERFORMANCE USING STANDARD INFUSION PUMP APPARATUS

Department of Anesthesia, Women’s College Hospital, 76 Grenville Street, Toronto, Ontario, M5S 1B2

INTRODUCTION

Postdural puncture headache (PDPH) is a common complication of dural puncture in parturients but cadaver studies suggest that the volume of CSF leakage and hence the incidence and severity of PDPH may be reduced by using smaller epidural needles (> 18g). Recently, a 23g catheter designed for use with a 19g epidural needle has become available for use. This study compared the in vitro performance of a 23g catheter with a standard 20g catheter using PCEA.

METHODS

Ten 23g (Pajunk, Germany) and 20g (Portex, Keene NH) closed end triple-port epidural catheters were connected to a syringe containing 50-ml of N saline, primed, then seated in a Graseby (Watford, UK) 3300 PCEA pump. Each catheter tip was pressurized to 20 cm H2O and the pump configured to deliver a 5-ml bolus of solution. The duration of time over which the bolus could be administered without pump occlusion was determined. A second 5-ml bolus was actuated with the catheter tip sitting in the barrel of a 10-ml syringe and the volume of solution recorded. The above procedures were then repeated using a 9-ml bolus of solution.

RESULTS

The differences between programmed and delivered boluses ranged from 0.5-1.0 ml for both types of catheters for each programmed bolus. 2-way RANOVA examining the differences in volume of delivery between 23g and 20g catheters did not reach statistical significance for 5-ml (p=0.10) or 9-ml (p=0.55). The minimum median (range) duration of time over which the 5-ml and 9-ml boluses could be administered without pump occlusion via the 23g catheter were 2(1.5–4.0) and 3(1.5–5.0) minutes respectively. All boluses administered via the 20g catheter were completed without pump occlusion in 1.5 minutes.

DISCUSSION

This experiment demonstrates the suitability of a 23g epidural catheter for use in one type of commonly used PCEA pump. Although the time taken to deliver a programmed bolus was longer with the 23g catheter, the actual volume of solution delivered by each catheter upon demand was similar. Further studies in vivo are required to determine whether this delay has a clinically significant impact upon the quality of labour analgesia provided.

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Purdie, N. L Articles by Angle, P. J Search for Related Content PubMed Articles by Purdie, N. L Articles by Angle, P. J