Abstract
Background A continuous spinal catheter is a reliable alternative to standard neuraxial techniques in obstetric anesthesia. Despite the potential advantages of intrathecal catheters, they remain underutilized due to fear of infection, nerve damage or post-dural puncture headache. In our tertiary care center, intrathecal catheters are either placed intentionally in high-risk obstetric patients or following inadvertent dural puncture using a 19-gauge macrocatheter passed through a 17-gauge epidural needle. Methods A retrospective review of 761 intrathecal catheters placed from 2001 to 2012 was conducted. An institutional obstetric anesthesia database was used to identify patients with intrathecal catheters. Medical records were reviewed for procedural details and complications. Results There were no serious complications, including meningitis, epidural or spinal abscess, hematoma, arachnoiditis, or cauda equina syndrome, associated with intrathecal catheters. The failure rates were 2.8% (3/108) for intentional placements and 6.1% (40/653) for placements following accidental dural puncture. The incidence of post-dural puncture headache was 41% (312/761) and the epidural blood patch rate was 31% (97/312). Conclusions This review demonstrates that intrathecal catheters are dependable and an option for labor analgesia and surgical anesthesia for cesarean delivery. Serious long-lasting complications are rare.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 30-36 |
| Number of pages | 7 |
| Journal | International Journal of Obstetric Anesthesia |
| Volume | 25 |
| DOIs | |
| State | Published - Feb 1 2016 |
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Keywords
- Continuous spinal catheter
- Intrathecal catheter
- Labor pain
- Obstetric anesthesia
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
- Obstetrics and Gynecology
Cite this
Complications of 761 short-term intrathecal macrocatheters in obstetric patients : A retrospective review of cases over a 12-year period. / Cohn, Jennifer; Moaveni, Daria; Sznol, J.; Ranasinghe, Jayanthie.
In: International Journal of Obstetric Anesthesia, Vol. 25, 01.02.2016, p. 30-36.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Complications of 761 short-term intrathecal macrocatheters in obstetric patients
T2 - A retrospective review of cases over a 12-year period
AU - Cohn, Jennifer
AU - Moaveni, Daria
AU - Sznol, J.
AU - Ranasinghe, Jayanthie
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background A continuous spinal catheter is a reliable alternative to standard neuraxial techniques in obstetric anesthesia. Despite the potential advantages of intrathecal catheters, they remain underutilized due to fear of infection, nerve damage or post-dural puncture headache. In our tertiary care center, intrathecal catheters are either placed intentionally in high-risk obstetric patients or following inadvertent dural puncture using a 19-gauge macrocatheter passed through a 17-gauge epidural needle. Methods A retrospective review of 761 intrathecal catheters placed from 2001 to 2012 was conducted. An institutional obstetric anesthesia database was used to identify patients with intrathecal catheters. Medical records were reviewed for procedural details and complications. Results There were no serious complications, including meningitis, epidural or spinal abscess, hematoma, arachnoiditis, or cauda equina syndrome, associated with intrathecal catheters. The failure rates were 2.8% (3/108) for intentional placements and 6.1% (40/653) for placements following accidental dural puncture. The incidence of post-dural puncture headache was 41% (312/761) and the epidural blood patch rate was 31% (97/312). Conclusions This review demonstrates that intrathecal catheters are dependable and an option for labor analgesia and surgical anesthesia for cesarean delivery. Serious long-lasting complications are rare.
AB - Background A continuous spinal catheter is a reliable alternative to standard neuraxial techniques in obstetric anesthesia. Despite the potential advantages of intrathecal catheters, they remain underutilized due to fear of infection, nerve damage or post-dural puncture headache. In our tertiary care center, intrathecal catheters are either placed intentionally in high-risk obstetric patients or following inadvertent dural puncture using a 19-gauge macrocatheter passed through a 17-gauge epidural needle. Methods A retrospective review of 761 intrathecal catheters placed from 2001 to 2012 was conducted. An institutional obstetric anesthesia database was used to identify patients with intrathecal catheters. Medical records were reviewed for procedural details and complications. Results There were no serious complications, including meningitis, epidural or spinal abscess, hematoma, arachnoiditis, or cauda equina syndrome, associated with intrathecal catheters. The failure rates were 2.8% (3/108) for intentional placements and 6.1% (40/653) for placements following accidental dural puncture. The incidence of post-dural puncture headache was 41% (312/761) and the epidural blood patch rate was 31% (97/312). Conclusions This review demonstrates that intrathecal catheters are dependable and an option for labor analgesia and surgical anesthesia for cesarean delivery. Serious long-lasting complications are rare.
KW - Continuous spinal catheter
KW - Intrathecal catheter
KW - Labor pain
KW - Obstetric anesthesia
UR - http://www.scopus.com/inward/record.url?scp=84959441463&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959441463&partnerID=8YFLogxK
U2 - 10.1016/j.ijoa.2015.08.006
DO - 10.1016/j.ijoa.2015.08.006
M3 - Article
C2 - 26421698
AN - SCOPUS:84959441463
VL - 25
SP - 30
EP - 36
JO - International Journal of Obstetric Anesthesia
JF - International Journal of Obstetric Anesthesia
SN - 0959-289X
ER -