Reina M A, Català-Puigbó E, López-García A, Amor E, Amador V, Arrizabalaga M, Aliaga-Font L
Servicio de Anestesiología y Reanimación, Hospital General de Móstoles, Madrid.
Rev Esp Anestesiol Reanim. 1997 Nov;44(9):352-6.
The increased use of the epidural route for administering opioids to treat chronic pain and the need to reduce complications as much as possible, has led some authors to recommend using micro filters to reduce catheter contamination. This study was motivated by the lack of technical information documenting epidural filters used routinely, as well as by the scarcity of literature describing their characteristics. Our aim was to investigate the true nature of the membrane pores, their characteristics and dimensions.
Samples from 30 epidural filters labelled "Porosity: 0.2 microns" from three different manufacturers were studied. Filters from Vygon, Braun and Abbot were labelled A, B and C, respectively. The samples were placed in six groups of five filters each, and 15 random studies were made of each sample. Three of the six groups were used to study prefiltration surfaces and the others to study postfiltration surfaces. Each sample was metalized with gold and its center was then studied by scanning electron microscope. Given that the pores were anfractuous, they were measured by taking the diameter of the largest circle fitting inside that could predict the size of the smallest spherical non elastic body that might be retained. The samples for measuring thickness were cryofractured for determining the number of filtration planes in the 15 filters.
Prefiltration surface: Pore diameters were 0.70 (0.66 to 0.74), 0.45 (0.41 to 0.49), and 2.077 (2.01 to 2.15) microns on the filtration surfaces of manufacturers A, B and C, respectively. The differences were significant (p < 0.01) and the pore shapes were also different. Postfiltration surface: The function pores of filters from manufacturers A and B measured 0.26 (0.25 to 0.28) and 0.26 (0.24 to 0.28) microns, and the differences were not significant. The pores of filters from company C were significantly larger (p < 0.01), measuring 0.46 (0.43 to 0.49) microns. There were significant differences (p < 0.001) in pore size on the pre- and postfiltration surfaces from all three manufacturers. Gauge: The five A, B and C filters averaged 130, 118 and 165 microns thick, respectively, with an average number of 140, 220 and 210 filtration planes, respectively.
The pores of filters for epidural use labelled "0.2 microns" actually had much larger pores on their prefiltration surfaces and throughout the membrane thickness. On the postfiltration surface, however, the diameters of pores on filters manufactured by Vygon and Braun approached 0.2 microns. Pores on filters manufactured by Abbot, however, were approximately 0.46 microns. We believe that in the future manufacturers should include more information in the documentation accompanying their filters.
硬膜外途径使用阿片类药物治疗慢性疼痛的情况日益增多,且需要尽可能减少并发症,这使得一些作者建议使用微滤器以减少导管污染。本研究的开展是由于缺乏关于常规使用的硬膜外滤器的技术信息,以及描述其特性的文献稀缺。我们的目的是研究膜孔的真实性质、特性和尺寸。
研究了来自三个不同制造商的30个标记为“孔隙率:0.2微米”的硬膜外滤器样本。来自威高(Vygon)、贝朗(Braun)和雅培(Abbot)的滤器分别标记为A、B和C。将样本分成六组,每组五个滤器,对每个样本进行15次随机研究。六组中的三组用于研究预过滤表面,其他组用于研究后过滤表面。每个样本用金进行金属化处理,然后通过扫描电子显微镜研究其中心部分。鉴于孔呈曲折状,通过测量能容纳在其中的最大圆的直径来测量孔,该直径可预测可能被截留的最小球形非弹性体的尺寸。用于测量厚度的样本进行冷冻断裂,以确定15个滤器中的过滤平面数量。
预过滤表面:制造商A、B和C的过滤表面上的孔径分别为0.70(0.66至0.74)、0.45(0.41至0.49)和2.077(2.01至2.15)微米。差异具有统计学意义(p < 0.01),且孔的形状也不同。后过滤表面:制造商A和B的滤器的功能孔尺寸为0.26(0.25至0.28)和0.26(0.24至0.28)微米,差异不显著。公司C的滤器的孔明显更大(p < 0.01),为0.46(0.43至0.49)微米。所有三个制造商的预过滤和后过滤表面的孔径存在显著差异(p < 0.001)。规格:五个A、B和C滤器的平均厚度分别为130、118和165微米,平均过滤平面数量分别为140、220和210个。
标记为“0.2微米”的硬膜外使用滤器在其预过滤表面以及整个膜厚度上实际具有大得多的孔。然而,在威高和贝朗制造的滤器的后过滤表面上,孔的直径接近0.2微米。然而,雅培制造的滤器上的孔约为0.46微米。我们认为,未来制造商应在其滤器附带的文档中包含更多信息。