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Bevel direction of epidural needles reliably predicts direction of catheter placement and contrast spread in human cadavers: results of a pilot study.

Abstract：

STUDY OBJECTIVE:To confirm the relationship between bevel orientation, catheter direction, and radiopaque contrast spread in the lumbar region. DESIGN:Pilot cadaver study. SETTING:Anatomy laboratory of a university hospital. MEASUREMENTS:Cadavers were randomized to two groups of 4 cadavers each. In Group 1, needle bevel direction at epidural entry was cephalad; in Group 2, it was caudad. After placement of each epidural catheter in L4-L5 interspace, 2 mL of radiopaque contrast was injected and a lumbar posterior-anterior radiograph was obtained. Catheter direction and direction of radiopaque contrast spread were collected. MAIN RESULTS:Due to the inability to access the epidural space secondary to surgical changes in the lumbar spine, one cadaver in the cephalad group was excluded. In 7 of 7 (100%) cadavers, the catheter tip direction according to the radiograph corresponded directly with bevel direction. CONCLUSIONS:A strong relationship exists between bevel orientation and catheter direction; however, catheter position does not reliably predict the direction in which the injected fluid spreads in all cadavers.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Shaparin N,Bernstein J,White RS,Kaufman A

doi

10.1016/j.jclinane.2014.04.004

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

587-90

issue

8

eissn

0952-8180

issn

1873-4529

pii

S0952-8180(14)00175-5

journal_volume

26

pub_type

杂志文章

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