A Comparison Between Open-End (Single Hole) and Closed-End (Three Lateral Holes) Epidural Catheters Complications and Quality of Sensory Blockade

Abstract

A randomised, single-blind study was conducted on 802 parturient women who required epidural analgesia, to compare open-end (single hole) with closed-end (three lateral holes) epidural catheters. The complication rate after catheter insertion was not statistically drferent between the two groups, but the number of unsatisfactory blocks was significantfy higher in the open-end group (p < 0.001). The closed-end catheters were easier and less painful to place, but gave a higher incidence of bloody taps. The open-end catheters caused sensory blockade to be more frequently unilateral and more frequently missed sensory segments. This resulted in a significantly higher number of open-end catheters that required replacement (p < 0.001). Open-end catheters despite their theoretical advantages in the detection of intravenous and subarachnoid placement caused an unacceptably high incidence of unsatisfactory sensory blockade.

RETRACTED: Accidental venous and dural puncture during epidural analgesia in obese parturients (BMI > 40 kg/m2): three different body positions during insertion

“…There is no ideal method for identification of intravascular catheter location [9][10][11][12][13][14][15]. The preference for patient position during the procedure is variable [16][17][18][19][20][21][22].…”

Paediatric lumbar epidurals: a comparison of 21‐G and 23‐G catheters in patients weighing less than 10 kg

“…Kinking has already been discussed above, catheter ‘occlusion’ is likely to be the result of a block of the single terminal orifice of smaller catheters. Interestingly, in a comparison of similar single endhole and multiple lateral‐hole catheters in obstetric patients, it was found that unsatisfactory sensory blockade was more common with the single terminal orifice catheter ( 5). Leakage of the infusate around the catheter is common in paediatric patients and is more frequent with decreasing age and weight.…”

Inefficient epidural block and frequency of its development during perioperative anesthesia in oncosurgery

“…Дані про те, що катетери з декількома отворами мають значно нижчу частоту неповного епідурального блоку підтверждені рядом авторів [7,8]. У їх підтримку Segal і співавт.…”