Kobayashi N
Department of Anesthesiology, Osaka Medical School, Takatsuki.
Masui. 1990 Mar;39(3):335-42.
The stiffness on bending of 7 types of epidural catheters was measured with the help of a cantilever beam. 1415 patients scheduled for lithotripsy, requiring epidural anesthesia, were selected and randomly assigned to receive one of the catheters. The patients were divided into 2 groups according to the resistance to insertion. The incidence of intravenous insertion, subarachnoid location and paresthesia during catheter insertion were assessed. The position of epidural catheters was studied radiographically in 1276 of 1415 patients. There were no significant difference among 7 types of epidural catheters as far as the incidence of intravenous insertion, subarachnoid insertion or straight lying of catheter in epidural space were concerned. When the catheter was hard or pushed against the resistance to insertion, the incidence of paresthesia increased. When the catheter was hard and pushed against the resistance to insertion, transforaminal escape increased. A soft catheter should be chosen to minimize the incidence of paresthesia or transforaminal escape.
借助悬臂梁测量了7种硬膜外导管的弯曲刚度。选择1415例计划进行碎石术且需要硬膜外麻醉的患者,并随机分配接受其中一种导管。根据插入阻力将患者分为2组。评估了静脉内插入、蛛网膜下腔定位和导管插入期间感觉异常的发生率。在1415例患者中的1276例中通过影像学研究了硬膜外导管的位置。就静脉内插入、蛛网膜下腔插入或导管在硬膜外腔的伸直情况的发生率而言,7种硬膜外导管之间无显著差异。当导管硬或插入时遇到阻力时,感觉异常的发生率增加。当导管硬且插入时遇到阻力时,经椎间孔逸出增加。应选择柔软的导管以尽量减少感觉异常或经椎间孔逸出的发生率。