Burstal R, Wegener F, Hayes C, Lantry G
Department of Anaesthesia, John Hunter Hospital, Newcastle, N.S.W.
Anaesth Intensive Care. 1998 Apr;26(2):147-51. doi: 10.1177/0310057X9802600203.
The use of subcutaneous tunnelling to prevent movement of epidural catheters was examined in a prospective controlled trial. There were 113 patients in the standard group and 100 in the tunnelled group. The groups were similar with respect to age, sex and weight. There were 176 thoracic catheters, and 37 lumbar catheters. Mean duration of catheterization in the tunnelled group was 3.5 +/- 1.3 days and in the standard group, 3.1 +/- 1.5 days. In total, 60 catheters moved significantly from their initial position: 17 (28%) moved inwards and 43 (72%) moved outwards. 159 catheters were still functioning at the time of their removal, 76 standard and 83 tunnelled. This represents 67 and 83% of the two groups respectively. Subcutaneous tunnelling was shown to prevent clinically significant inwards (P = 0.043) and outwards (P = 0.0005) movement of epidural catheters and is more likely to result in a functional epidural blockade at the time of catheter removal (P = 0.0084).
在一项前瞻性对照试验中，研究了采用皮下隧道技术防止硬膜外导管移位的情况。标准组有113例患者，隧道组有100例患者。两组在年龄、性别和体重方面相似。共有176根胸段导管和37根腰段导管。隧道组的平均置管时间为3.5±1.3天，标准组为3.1±1.5天。总共有60根导管从其初始位置发生了明显移位：17根（28%）向内移位，43根（72%）向外移位。159根导管在拔除时仍在发挥作用，标准组76根，隧道组83根。这分别占两组的67%和83%。结果显示，皮下隧道技术可防止硬膜外导管发生具有临床意义的向内（P = 0.043）和向外（P = 0.0005）移位，并且在拔除导管时更有可能形成有效的硬膜外阻滞（P = 0.0084）。
