Effect of injecting saline into epidural space before catheter insertion on frequency of intravascular placement

ABSTRACT

The objective of the study was to determine if injecting 10 ml saline before threading epidural catheter can decrease the accidental intravascular placement in epidural space. Interventional experimental study. Department of Anaesthesia, Hameed Latif Hospital Lahore, affiliated with College of Physicians Surgeons Pakistan, from September 2008 to August 2009. One hundred healthy women requesting Epidural labour analgesia were prospectively randomized to receive either no epidural injection [dry group, n = 50] acting as a control or epidural 10 ml saline injection [saline group, n = 50] before epidural catheter placement. A nylon multiport catheter was then threaded 3 cm into the epidural space and the needle was removed. We diagnosed iv catheter placement if blood was freely aspirated, or if the mother became tachycardic after injection of epinephrine 15 microg. The groups were similar in age [P value=0.32]. We identified iv catheter placement in 2/50 saline group and 7/50 dry group patients [4% vs 14%, P value= 0.16]. Intravenous catheter placement was identified by initial blood aspiration [two saline, seven dry group patients]. No anesthetic complications occurred, including hypoxemia,patient complaint of difficulty swallowing, intrathecal catheter placement, respiratory arrest, or subsequent iv or intrathecal catheter migration. Our study results have shown that injecting 10 ml saline before threading epidural catheter has insignificant effect on decreasing the accidental intravascular placement in epidural space