A comparison between open‐end (single hole) and closed‐end (three lateral holes) epidural catheters

Abstract

Summary

A new epidural catheter

“…Aspiration of blood through the epidural catheter immediately following insertion was classified as a bloody tap and was often associated with a definite click on catheter insertion. The incidence was similar with both catheter types (6.5%), and was lower than that recorded in previous work with multiholed catheters, but higher than the findings for singleholed catheters [2,3]. Small volumes of altered blood were aspirated on four occasions just prior to top-up, twice in each group, but no constant flow of blood was obtained at this time.…”

“…There was no significant difference between the groups in the reported incidence of unsatisfactory blocks (6%), with unilateral blocks being commoner than missed segments, as in previous studies, where the frequency of unsatisfactory blocks has been reported as 14% and 21% [2,3]. Four catheters required resiting, an incidence of 1 % compared to 3% and 6% in other studies [2,3].…”

“…Four catheters required resiting, an incidence of 1 % compared to 3% and 6% in other studies [2,3]. One standard and two 'closer-eye' catheters were replaced following inadequate blocks, and one 'closer-eye' catheter slipped out with patient movement.…”

“…In obstetric patients, Michael, Richmond and Birks [2] reported that the singleholed catheters caused an unacceptably high incidence of unsatisfactory sensory block (33%), mostly uni-lateral and missed segment blocks, and had to be replaced in as many as 6% of cases. Although the multiholed catheters had a higher incidence (loo/,) of bloody tap, only 14% of blocks were rated as unsatisfactory and 1% had to be replaced.…”

“…The new 'closer-eye' catheter was designed to reduce the possibility of a multicompartment block, whilst retaining the three eyes which many believe are less likely to become blocked by clot or adjacent tissues than a single terminal eye [2,8]. In addition, the presence of three eyes is claimed to allow a wider, more uniform spread of solution, with a better quality of block [2], although many would dispute this [3].…”