A Novel Balloon-Inflatable Catheter for Percutaneous Epidural Adhesiolysis and Decompression

Epidural adhesions cause pain by interfering with the free movement of the spinal nerves and increasing neural sensitivity as a consequence of neural compression. To remove adhesions and deliver injected drugs to target sites, percutaneous epidural adhesiolysis (PEA) is performed in patients who are unresponsive to conservative treatments. We describe four patients who were treated with a newly developed inflatable balloon catheter for more effective PEA and relief of stenosis. In the present patients, treatments with repetitive epidural steroid injection and/or PEA with the Racz catheter or the NaviCath did not yield long-lasting effects or functional improvements. However, PEA and decompression with the inflatable balloon catheter led to maintenance of pain relief for more than seven months and improvements in the functional status with increases in the walking distance. The present case series suggests that the inflatable balloon catheter may be an effective alternative to performing PEA when conventional methods fail to remove adhesions or sufficiently relieve stenosis.

The comparative study of flow rate between IV extension tube and epidural catheter connected to patient controlled analgesia device / 대한마취과학회지

BACKGROUND: Patient controlled analgesia (PCA) device is known to be an effective method for acute and chronic pain control and the administration route for PCA pump is various. The representative routes are intravenous and epidural space. The aim of this study is to investigate the influence of catheter diameter on flow rate. METHODS: IV extension tube or epidural catheter connected to Mechanical- or balloon-type PCA devices were examined (100 ml, 2 ml/hr). There were four groups each of 5 experiments: Group I: Mechanical-type pump + IV extension tube, Group II: Mechanical-type pump + epidural catheter, Group III: Balloon-type pump + IV extension tube, Group IV: Balloon-type pump + epidural catheter. The flow rate was indirectly measured by the weight change of collecting infusate bottle. Infusion fluid was distilled water. Experiment was carried out in a laboratory room with a constant room temperature of 20-22degrees C. RESULTS: Infusion rate differed significantly among the groups, exhibiting flow rates within +/-15% of their expected rate for 28% (group IV) to 100% (group I) of their infusion duration. The mean Infusion rate in group I was significantly more rapid than that in other groups. The mean flow rate in group III was higher than that in group IV (P<0.05). CONCLUSIONS: These results indicate that the use of an epidural catheter with a small internal diameter could decrease the flow rate of PCA device.