Incidence of intravascular insertion in thoracic epidural catheterization by using real time fluoroscopy

Kim, Sae Young; Kim, Yun Young; Kim, Ae Ra

doi:10.4097/kjae.2012.62.3.251

Cited by 7 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, fluoroscopy allows the operator to detect inadvertent catheter positioning in the intrathecal space, subdural space, and blood vessels. 39 Unfortunately, in many centers, the additional equipment, manpower (radiology technologist), and radiation exposure often curtail its routine use in surgical and obstetrical patients.…”

Section: Radiographic Imagingmentioning

confidence: 99%

Confirmation of Loss-of-Resistance for Epidural Analgesia

Tran

González

Bernucci

et al. 2015

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

Section: Radiographic Imagingmentioning

confidence: 99%

Confirmation of Loss-of-Resistance for Epidural Analgesia

Tran

González

Bernucci

et al. 2015

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

“…Reports have indicated the incidence of paresthesia during the epidural catheter insertion from 44% [8] to as high as 57% in pregnant mothers [9]. In addition, the prevalence of unintentional vascular puncture with radiologic confirmation has been reported at 1.4% [10]. In this study, the reported cases of paresthesia in the cephalad and caudad groups were 15.5% and 18.4%, respectively.…”

Section: Discussionmentioning

confidence: 55%

Direction of catheter insertion and the incidence of paresthesia during continuous epidural anesthesia in the elderly patients

Kim

Lee

Kim

2013

Korean J Anesthesiol

View full text Add to dashboard Cite

BackgroundContinuous epidural anesthesia is useful for endoscopic urologic surgery, as mostly performed in the elderly patients. In such a case, it is necessary to obtain successful sacral anesthesia, and the insertion of epidural catheter in the caudad direction may be needed. However, continuous epidural catherization has been related to paresthesias. This study aimed to evaluate the effects of the direction of the catheter insertion on the incidence of paresthesias in the elderly patients.MethodsTwo hundred elderly patients scheduled for endoscopic urologic surgery were enrolled. The epidural catheter was inserted at L2-3, L3-4, and L4-5 using the Tuohy needle. In Group I (n = 100), the Tuohy needle with the bevel directed the cephalad during the catheter insertion. In Group II (n = 100), it directed the caudad. During the catheter insertion, an anesthesiologist evaluated the presence of paresthesias and the ease or difficulty during the catheter insertion.ResultsIn Group I (n = 97), 15.5% of the patients had paresthesias versus 18.4% in Group II (n = 98), and there was no significant difference between the two groups. In paresthesia depending on the insertion site and the ease or difficulty during the catheter insertion, there were no significant differences between the two groups.ConclusionsOur results concluded that the direction of epidural catheter insertion did not significantly influence the incidence of paresthesias in the elderly patients.

show abstract

“…14,16,22 However, its use is labor and time intensive, requires additional equipment and often manpower, and exposes the patient and medical personnel to radiation.…”

Section: Discussionmentioning

confidence: 99%

Raman Spectroscopy Differentiates Each Tissue from the Skin to the Spinal Cord

et al. 2016

View full text Add to dashboard Cite

Background Neuraxial anesthesia and epidural steroid injection techniques require precise anatomical targeting to ensure successful and safe analgesia. Previous studies suggest that only some of the tissues encountered during these procedures can be identified by spectroscopic methods, and no previous study has investigated the use of Raman, diffuse reflectance, and fluorescence spectroscopies. The authors hypothesized that real-time needle-tip spectroscopy may aid epidural needle placement and tested the ability of spectroscopy to distinguish each of the tissues in the path of neuraxial needles. Methods For comparison of detection methods, the spectra of individual, dissected ex vivo paravertebral and neuraxial porcine tissues were collected using Raman spectroscopy (RS), diffuse reflectance spectroscopy, and fluorescence spectroscopy. Real-time spectral guidance was tested using a 2-mm inner-diameter fiber-optic probe-in-needle device. Raman spectra were collected during the needle’s passage through intact paravertebral and neuraxial porcine tissue and analyzed afterward. The RS tissue signatures were verified as mapping to individual tissue layers using histochemical staining and widefield microscopy. Results RS revealed a unique spectrum for all ex vivo paravertebral and neuraxial tissue layers; diffuse reflectance spectroscopy and fluorescence spectroscopy were not distinct for all tissues. Moreover, when accounting for the expected order of tissues, real-time Raman spectra recorded during needle insertion also permitted identification of each paravertebral and neuraxial porcine tissue. Conclusions This study demonstrates that RS can distinguish the tissues encountered during epidural needle insertion. This technology may prove useful during needle placement by providing evidence of its anatomical localization.

show abstract

Incidence of intravascular insertion in thoracic epidural catheterization by using real time fluoroscopy

Cited by 7 publications

References 22 publications

Confirmation of Loss-of-Resistance for Epidural Analgesia

Confirmation of Loss-of-Resistance for Epidural Analgesia

Direction of catheter insertion and the incidence of paresthesia during continuous epidural anesthesia in the elderly patients

Raman Spectroscopy Differentiates Each Tissue from the Skin to the Spinal Cord

Contact Info

Product

Resources

About