Abstract ID: A3

Abstract Title: Comparative Evaluation of Three Epidural Catheters for Localisation of the Epidural Space Using the Epidural Pressure Waveform

Authors: Pelletier J¹, de Medicis É²
University of Sherbrooke Fleurimont Quebec Canada¹, University of Sherbrooke Fleurimont Quebec Canada²
Poster Type: Poster

ABSTRACT BODY

Comparative evaluation of three epidural catheters for localisation of the epidural space using the epidural pressure waveform

Jocelyn Pelletier MD, Étienne de Medicis M Sc MD FRCP ( c), Jean-Pierre Tétrault MD FRCP ( c), René Martin MD FRCP (c ), Lucie Laroche BN and Marie-Pierre Garant M Sc

Introduction:
Epidural pressure waveform (EPWF) is a method of confirming epidural catheter placement using the pressure waves transmitted from the dura¹.

Purpose :
1- To compare three different types of catheter during epidural placement using the EPWF.
2- Determine the amount of saline for optimal lecture of the EPWF.

Methods:
60 patients were randomly assigned to 3 groups: Portex 20G (nonstimulating/3 holes), Portex Duraflex (stimulating/3 holes) and Arrow Flextip Plus (stimulating/1 hole). After epidural placement with air lost resistance, an EPWF was recorded (reading of 10 seconds). Afterwards, saline was added by increments of 2.5 cc to a total of 10 cc with a measure of EPWF at every 2.5cc. Thereafter, a preset dose of local anesthetic was administered.

Results:
Statistical analysis (logistic regression for repeated measures) demonstrated a difference between catheters (p=0.0013) and the progressive impact of injected saline (p<0.0001). The groups Portex and Portex Duraflex were not different (p=0.2466). There was a significant difference between the Arrow and Portex groups (p=0.0028/p=0.0116). That difference was demonstrated at baseline (p<0.0001) and 2.5cc (p=0.0027) of injected saline. No significant differences between the catheters were noted between 5cc, 7.5cc and 10cc. figure 1

Conclusion:
These data suggest that the Portex catheter optimise the EPWF readings at low volume of saline compared to the Arrow catheter and that the initial optimal saline volume for lecture during EPWF readings is 5 cc.

1 Étienne de Medicis et al. Prospective comparative evaluation of 2 indirect methods of confirming the location of an epidural space catheter for postop analgesia. AA 2005 in printing

ATTACHED FILES

A3_Fig.doc

Reg Anesth Pain Med 2005; 30(3):A3