Department of Anesthesia, Theodor Bilharz Research Institute, Ministry of Scientific Research, P.O. Box 30, Warak El-Hadar, Kornish El-Nile, Imbaba, Giza, 12411, Egypt.
J Anesth. 2013 Aug;27(4):607-10. doi: 10.1007/s00540-013-1567-y. Epub 2013 Feb 14.
We are introducing a new continuous hydrostatic pressure system for identification and catheterization of epidural space in adults. One hundred and eight patients scheduled for elective endoscopic urological procedures were enrolled in this prospective randomized study. They were assigned to perform loss of resistance epidural technique by either the conventional saline-filled syringe (group C) or the new pressure technique (group P). The latter depends on observing passage of free flow of pressurized normal saline (50 mmHg) connected to epidural needle during its advancement, and then the epidural catheter was inserted to "float" easily while saline was flowing. Ten ml of bupivacaine 0.5 % with 50 μg fentanyl were injected. Time to identify epidural space, number of attempts, ease of catheterization, sensory and motor block by Bromage scale after 20 min, quality of anesthesia and any side effects were recorded. Significant reduction was found in group P versus group C concerning time to identify epidural space [20 (6-40) vs. 60.5 (23-75) s with p = 0.001], number of attempts [1 (1-2) vs. 1 (1-4) with p = 0.02] and motor block [1 (0-3) vs. 2 (0-2) with p = 0.02], respectively. No significant difference in epidural catheterization, sensory block, quality of anesthesia and incidence of side effects. We concluded that this new technique is an easy way to identify epidural space using available tools in the operating room.
我们引入了一种新的连续静压系统，用于识别和置管成人硬膜外腔。本前瞻性随机研究纳入了 108 例行择期内镜泌尿科手术的患者。他们被分为两组，分别采用传统盐水填充注射器（C 组）或新的压力技术（P 组）进行阻力损失硬膜外技术。后者取决于观察到连接到硬膜外针的加压生理盐水（50mmHg）自由流动的过程，然后将硬膜外导管插入，以便在生理盐水流动时“漂浮”。注入 0.5%布比卡因 10ml 加 50μg 芬太尼。记录识别硬膜外腔的时间、尝试次数、导管插入的难易程度、20 分钟后 Bromage 量表的感觉和运动阻滞程度、麻醉质量和任何副作用。与 C 组相比，P 组在识别硬膜外腔的时间[20（6-40）与 60.5（23-75）秒，p=0.001]、尝试次数[1（1-2）与 1（1-4），p=0.02]和运动阻滞[1（0-3）与 2（0-2），p=0.02]方面均有显著减少。但硬膜外导管插入、感觉阻滞、麻醉质量和副作用发生率无显著差异。我们得出结论，这种新技术是一种使用手术室现有工具识别硬膜外腔的简便方法。
