Gotou M, Yokoyama K
Department of Anesthesiology, Daiichi Hospital, Nippon Medical School, Tokyo.
Masui. 1993 Jun;42(6):922-5.
It is known that the course of catheter placement is related to the firmness of catheter. This paper reports the results of roentgenographic analysis of the location of catheters (20G PERIFIX SOFT catheter-B. Braun Melsungen-blind tip with three side holes) inserted into the lumbar epidural space in 20 patients. Epidural catheterization was performed in patients on the lateral decubitus position. The epidural space was identified by the loss of resistance technique with a 17 gauge Tuohy needle, with median approach. Post-operatively, the injection of 0.5 ml radiopaque solution (Iopamidol) through the catheter was made. A-P X-ray film showed that 70 per cent of epidural catheters were inserted straightly cephalad. It has been reported that the optimum hardness and blind tip of the catheter are required for the good epidural placement. PERIFIX SOFT epidural catheter showed the good result for this purpose. From the recent anatomical observation by MRI, epi-dural space takes various figures depend on the location. Since posterior median part is the widest part in lumbar region, catheter placement should be done in this area. This will increase the success of straight placement of the epidural catheter.
众所周知，导管置入的过程与导管的硬度有关。本文报告了对20例患者插入腰段硬膜外间隙的导管（20G PERIFIX SOFT导管 - 贝朗医疗公司生产的盲端带三个侧孔导管）位置进行X线分析的结果。患者在侧卧位下进行硬膜外导管置入。采用17号Tuohy针经正中入路，通过阻力消失技术确定硬膜外间隙。术后，通过导管注入0.5 ml不透X线的溶液（碘帕醇）。前后位X线片显示70%的硬膜外导管向头侧笔直插入。据报道，为了实现良好的硬膜外置入，需要导管具备最佳的硬度和盲端。PERIFIX SOFT硬膜外导管在此方面显示出良好的效果。根据最近通过MRI进行的解剖学观察，硬膜外间隙的形态因位置而异。由于后正中部分是腰段最宽的部分，导管应在此区域置入。这将提高硬膜外导管笔直置入的成功率。
