Pressure waveform-guided epidural catheter placement in comparison to the loss-of-resistance conventional method

• Published in: Journal of clinical anesthesia Vol. 26; no. 5; pp. 395 - 401
• Main Authors: Gong, Yuhua, MD, Shi, Haixia, MD, Wu, Jie, MD, Labu, Danbaila, MD, Sun, Junzhi, MD, Zhong, Haiyan, MD, Li, Libiao, MD, Xin, Xuedong, MD, Wang, Ling, MD, Wu, Lifang, MD, Ma, Daqing, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2014; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia; Anesthesia & Perioperative Care; Anesthesia, Epidural - methods; Catheterization; Catheterization - methods; Catheters; Child; Child, Preschool; Cohort Studies; Electrocardiography; Epidural anesthesia; Epidural catheter placement: complications; Female; Hospitals, University; Humans; Loss-of-resistance technique; Male; Medical malpractice; Methods; Middle Aged; Pain management; Pain Medicine; Patient satisfaction; Patients; Pressure transducers; Pressure waveform-guided epidural catheter placement; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; Surgical Procedures, Operative - methods; Young Adult; Loss-of-resistance technique; Catheterization; Pressure waveform-guided epidural catheter placement; Epidural anesthesia; Epidural catheter placement: complications
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2014.01.015

Abstract Study Objectives To investigate pressure waveform-guided epidural catheter placement (PWEP) and its effect in clinical practice. Design Single-center, prospective cohort study. Setting University teaching hospital. Patients 3,326 patients undergoing thoracic, abdominal, and lower limb surgery. Interventions 1,614 underwent PWEP and 1,664 had the loss-of-resistance (LOR) technique. Measurements Anesthesia success and catheter replacement-related complications were recorded. Main Results The specificity and sensitivity of PWEP was higher than LOR, and it also provided higher satisfaction with anesthesia when compared with the LOR technique (62.8% vs 45.6 %; P < 0.05). PWEP also performed better than LOR in risk of anesthesia failure (0.4% vs 1.1%; P < 0.05) and catheter replacement-related complications (0% vs 0.6%; P < 0.05). Conclusion PWEP is a reliable and useful technique for epidural catheter placement.