Comparison of Incremental Spinal Anaesthesia Using a 32-Gauge Catheter With Extradural Anaesthesia for Elective Caesarean Section

Kestin, I. G.; Madden, A.P.; Mulvein, J.T.; Goodman, Neville W.

doi:10.1093/bja/66.2.232

Cited by 53 publications

(11 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study, two of the 22 women in the CSA group were excluded, one because of failure to identify the subarachnoid space and the other because the catheter could not be placed. 24 This represents a failure rate of 9% compared with 20% in our study. Again there are significant differences between this study and ours as a 32-guage catheter through needle was used.…”

Section: Discussionmentioning

confidence: 44%

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] There are few studies in the literature assessing the efficacy and safety of CSA in obstetrics, whether descriptive or comparative studies. [22][23][24][25][26] The primary objective of this study was to assess the efficacy and safety of CSA with the catheter-overneedle technique (Spinocath Ò ) when used for elective cesarean delivery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Observational study of continuous spinal anesthesia with the catheter-over-needle technique for cesarean delivery

Alonso

Gilsanz

Gredilla

et al. 2009

International Journal of Obstetric Anesthesia

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Observational study of continuous spinal anesthesia with the catheter-over-needle technique for cesarean delivery

Alonso

Gilsanz

Gredilla

et al. 2009

International Journal of Obstetric Anesthesia

View full text Add to dashboard Cite

“…For spinal needles, the duration of PDPH ranged from one to seven days. 15,22,32,34,[37][38][39]44 Further analysis of the data on onset and duration was not attempted as the data were confounded by differences in prophylactic and therapeutic interventions between studies and by uncertainty on the length of patient follow-up. Median patient follow-up was six days in the eight studies 9,17,27,31,33,37,39,49 that reported length of follow-up along with data on onset or duration of PDPH.…”

Section: Dp and Pdph Ratesmentioning

confidence: 99%

PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies

Choi

Galinski

Takeuchi

et al. 2003

Can J Anesth/J Can Anesth

326

182

View full text Add to dashboard Cite

P Pu ur rp po os se e: : Postdural puncture headache (PDPH) is an iatrogenic complication of neuraxial blockade. We systematically reviewed the literature on parturients to determine the frequency, onset, and duration of PDPH. M Me et th ho od ds s: :Citations on PDPH in the obstetrical population were identified by computerized searches, citation review, and hand searches of abstracts and conference proceedings. Citations were included if they contained extractable data on frequency, onset, or duration of PDPH. Using meta-analysis, we calculated pooled estimates of the frequency of accidental dural puncture for epidural needles and pooled estimates of the frequencies of PDPH for epidural and spinal needles.R Re es su ul lt ts s: : Parturients have approximately a 1.5% [95% confidence interval (CI) 1.5% to 1.5%) risk of accidental dural puncture with epidural insertion. Of these, approximately half (52.1%; 95% CI, 51.4% to 52.8%) will result in PDPH. The risk of PDPH from spinal needles diminishes with small diameter, atraumatic needles, but is still appreciable (Whitacre 27-gauge needle 1.7%; 95% CI, 1.6% to 1.8%). PDPH occurs as early as one day and as late as seven days after dural puncture and lasts 12 hr to seven days. C Co on nc cl lu us si io on n: : PDPH is a common complication for parturients undergoing neuraxial blockade. Objectif : Les céphalées post-ponction durale (CPPD) sont une complication iatrogène du bloc neuraxial. Une revue systématique des publications sur les parturientes a permis de déterminer la fréquence, le délai d'installation et la durée des CPPD. Méthode : Les citations sur les CPPD dans la population obstétricale ont été repérées par des recherches informatisées, la revue des références et des recherches manuelles de résumés et de comptes rendus de conférences. Les références retenues devaient comporter des données sur la fréquence, le délai d'installation et la durée des

show abstract

“…Continuous spinal anaesthesia is reported to offer more haemodynamic stability over continuous epidural or single-dose spinal anaesthesia [21][22][23][24]. Continuous spinal anaesthesia is reported to offer more haemodynamic stability over continuous epidural or single-dose spinal anaesthesia [21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Regional anaesthesia with a subarachnoid microcatheter for Caesarean section in a parturient with aortic stenosis

Pittard

Vucevic

1998

Anaesthesia

View full text Add to dashboard Cite

SummaryWe present a woman in her first pregnancy, with known aortic stenosis prior to conception, who successfully underwent regional anaesthesia for an elective Caesarean section using a subarachnoid microcatheter. The anaesthetic management of patients with aortic stenosis requiring noncardiac surgery is a complex and contentious matter, particularly when the situation is compounded by the physiological changes accompanying pregnancy and delivery. This is the first reported use of a subarachnoid microcatheter in such a patient. The choice of technique is discussed and compared with other options for providing anaesthesia. Patients with aortic stenosis are at risk of increased morbidity and mortality when undergoing anaesthesia [1]. Their compensatory left ventricular hypertrophy renders them vulnerable to ischaemia and they are difficult to resuscitate [2]. The added stress of the physiological changes of pregnancy and delivery can result in an unstable situation with maternal mortality being quoted as 17% and a perinatal mortality of 32% [3]. The choice of anaesthetic should be appropriate to the well-being of both mother and fetus. There are very few reports in the literature regarding the anaesthetic management of patients with aortic stenosis requiring delivery by Caesarean section [4][5][6][7] and the successful use of a subarachnoid microcatheter for this procedure has not been previously reported. Case historyA 21-year-old Asian primigravida, known to have aortic stenosis, presented for an elective Caesarean section at 36 weeks gestation. Prior to conception she had been under review by a cardiologist and at this time she had no cardiac-related symptoms and was otherwise fit and well. She was noted to have an ejection systolic murmur graded 4/6 and a pressure gradient across the valve, estimated by echocardiography, of 48 mmHg. Her electrocardiograph (ECG) was normal.Her pregnancy had progressed uneventfully and, when reviewed by the cardiologist at 16 weeks gestation, she was normotensive, in sinus rhythm and there had been a slight increase in her pressure gradient to 57 mmHg. The echocardiograph showed good left ventricular function with no significant hypertrophy. The decision was made by her consultant obstetrician to deliver the baby by Caesarean section at 36 weeks gestation and she was referred for an anaesthetic opinion.Twenty-four hours prior to surgery she was found to be fit and well, in sinus rhythm, normotensive and with no signs or symptoms of cardiac failure. After a full discussion with the patient and having explained the advantages and disadvantages of both general and regional anaesthesia it was decided to employ a regional anaesthetic technique. It was felt that the use of a spinal microcatheter would allow precise titration of local anaesthetic to effect and thereby minimise physiological changes.Following an overnight fast and routine gastric acid prophylaxis, the patient was transferred to the delivery suite anaesthetic room. A 14 gauge peripheral cannula was inserted under local...

show abstract

Comparison of Incremental Spinal Anaesthesia Using a 32-Gauge Catheter With Extradural Anaesthesia for Elective Caesarean Section

Cited by 53 publications

References 7 publications

Observational study of continuous spinal anesthesia with the catheter-over-needle technique for cesarean delivery

Observational study of continuous spinal anesthesia with the catheter-over-needle technique for cesarean delivery

PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies

Regional anaesthesia with a subarachnoid microcatheter for Caesarean section in a parturient with aortic stenosis

Contact Info

Product

Resources

About