Royal Gwent Hospital, Newport, UK.
Anaesthesia. 2012 Oct;67(10):1119-24. doi: 10.1111/j.1365-2044.2012.07248.x. Epub 2012 Jul 16.
Disconnection of an epidural catheter from its connector may result in patient harm and commonly requires resiting of the epidural. Clamp-connector designs such as the novel Portex EpiFuse™ potentially offer an improved safety profile over screw-cap designs such as the Tuohy-Borst, but comparative studies are limited. We therefore compared the tensile strength of EpiFuse and Tuohy-Borst connectors in a laboratory setting. We further sought to establish whether operator modification of the EpiFuse increased its vulnerability to disconnection. The median (IQR [range]) force to induce disconnection was 8.0 (4.1-12.8 [0.0-22.6]) N for Tuohy-Borst connectors and 16.4 (15.2-17.7 [5.7-18.9]) and 15.9 (15.0-16.9 [5.8-18.1]) N for standard and modified EpiFuse connectors, respectively (p<0.0001). The Tuohy-Borst was also less likely to meet British Standard requirements (13/20 sets vs 19/20 and 20/20, p=0.002). Modification of the EpiFuse did not affect lumen patency or connection strength. We conclude that under controlled conditions, EpiFuse connectors are superior to Tuohy-Borst connectors.
硬膜外导管与其接头断开可能导致患者受伤，通常需要重新置管。与螺丝帽设计（如 Tuohy-Borst）相比，夹扣式接头设计（如 Portex EpiFuse™）在安全性方面具有潜在优势，但相关比较研究有限。因此，我们在实验室环境下比较了 EpiFuse 和 Tuohy-Borst 接头的拉伸强度。我们还试图确定操作人员对 EpiFuse 的修改是否会增加其断开的脆弱性。Tuohy-Borst 接头引起断开的中位数（IQR [范围]）力为 8.0（4.1-12.8 [0.0-22.6]）N，标准和改良 EpiFuse 接头分别为 16.4（15.2-17.7 [5.7-18.9]）和 15.9（15.0-16.9 [5.8-18.1]）N（p<0.0001）。Tuohy-Borst 也更不可能符合英国标准要求（13/20 组与 19/20 和 20/20 相比，p=0.002）。EpiFuse 的修改并未影响管腔通畅性或连接强度。我们的结论是，在受控条件下，EpiFuse 接头优于 Tuohy-Borst 接头。
