• Regional anesthesia · Nov 1994

    Randomized Controlled Trial Clinical Trial

    Epidural catheters for obstetrics. Terminal hole or lateral eyes?

    • C B Collier and S P Gatt.
    • Department of Anaesthetics, Royal Hospital for Women, Paddington, N.S.W., Australia.
    • Reg Anesth. 1994 Nov 1;19(6):378-85.

    Background And ObjectivesControversy exists over the choice of the ideal epidural catheter for obstetric use, particularly whether the catheter should have a single terminal hole or three lateral eyes.MethodsA randomized single-blind study of 200 obstetric patients undergoing epidural block for analgesia in labor or for cesarean delivery was undertaken, using either a catheter with a terminal hole or three lateral eyes. The extent and quality of the block was recorded, as well as the presence of any complications.ResultsThe study was abandoned after 102 patients had been assessed, as the incidence of unsatisfactory blocks with terminal eye catheters was found to be unacceptably high (32%), when compared with the lateral eye catheters (12%) (P < .05). Four of the terminal eye catheters (8%) had to be resited compared with one of the lateral eye catheters (2%). One case of intravascular injection (2%) occurred through a terminal eye catheter, despite repeated negative attempts at aspiration.ConclusionsThe use of terminal eye epidural catheters in our obstetric patients has led to an unacceptably high incidence of both unsatisfactory blocks and catheter replacement. Lateral eye catheters produced better results in our circumstances.

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