Administration of local anaesthetics through epidural needle before catheter insertion does not improve the quality of anaesthesia or reduce catheter related complications

ABSTRACT

The objective of this study was to compare the effect of injecting local anaesthetics through epidural needle and catheter on quality of anaesthesia and catheter related complications. We randomized 60 patients into 2 equal groups; in the Needle Group [n=30], catheters were inserted after injection of a full dose of local anesthetic through the needle. In the Catheter Group [n=30], the catheters were inserted immediately after identification of the epidural space; local anesthetic was then injected via the catheter. The groups were compared for paresthesias, inability to advance the catheter, intravenouos or subarachnoid catheter placement; sensory and motor block were assessed 20 min after the injection of local anesthetic. Statistical analysis was performed by SPSS for Windows [version 10.0] Patient characteristics were analyzed using the t-test for independent groups. Block height, perioperative anesthesia quality and incidences of catheter related complications were analyzed using chi square test. Thoracic level sensory block and motor block was comparable in both the groups. Frequency of paresthesia during catheter placement was comparable; [23.3% versus 13.3% P=0.3]. Intra-vascular catheterization occurred in 23.3% versus 10% of patients in the catheter and needle groups, respectively [P=0.166]. Excellent surgical conditions were statistically similar in both the groups. Injecting local anaesthetic through the epidural needle before catheter placement does not reduce catheter-related complications or improve the qualityof epidural anesthesia