Collier C B, Gatt S P
Department of Anaesthetics, Royal Hospital for Women, Paddington, N.S.W., Australia.
Reg Anesth. 1994 Nov-Dec;19(6):378-85.
Controversy exists over the choice of the ideal epidural catheter for obstetric use, particularly whether the catheter should have a single terminal hole or three lateral eyes.
A randomized single-blind study of 200 obstetric patients undergoing epidural block for analgesia in labor or for cesarean delivery was undertaken, using either a catheter with a terminal hole or three lateral eyes. The extent and quality of the block was recorded, as well as the presence of any complications.
The study was abandoned after 102 patients had been assessed, as the incidence of unsatisfactory blocks with terminal eye catheters was found to be unacceptably high (32%), when compared with the lateral eye catheters (12%) (P < .05). Four of the terminal eye catheters (8%) had to be resited compared with one of the lateral eye catheters (2%). One case of intravascular injection (2%) occurred through a terminal eye catheter, despite repeated negative attempts at aspiration.
The use of terminal eye epidural catheters in our obstetric patients has led to an unacceptably high incidence of both unsatisfactory blocks and catheter replacement. Lateral eye catheters produced better results in our circumstances.
对于产科使用的理想硬膜外导管的选择存在争议，尤其是导管应具有单个末端孔还是三个侧孔。
对200例接受硬膜外阻滞以进行分娩镇痛或剖宫产的产科患者进行了一项随机单盲研究，使用带有末端孔或三个侧孔的导管。记录阻滞的范围和质量以及任何并发症的发生情况。
在评估了102例患者后，该研究被放弃，因为与侧孔导管（12%）相比，末端孔导管阻滞效果不满意的发生率高得令人无法接受（32%）（P <.05）。与侧孔导管中的一根（2%）相比，四根末端孔导管（8%）需要重新放置。尽管反复进行抽吸均为阴性，但仍有一例（2%）通过末端孔导管发生血管内注射。
在我们的产科患者中使用末端孔硬膜外导管导致阻滞效果不满意和导管更换的发生率高得令人无法接受。在我们的情况下，侧孔导管产生了更好的结果。
