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KMID : 0614520030130010090
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Journal of the Korean Pain Research Society
2003 Volume.13 No. 1 p.90 ~ p.93
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Effect of Dural Puncture with a Spinal Needle on the Spread of Epidural Injection
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Lee Jong-Yeon
Gill Hyun-Jue
Yang Hyun-Jung
Kim Myoung-Hee
Kim Min-Ku
Kim Jae-Jung
Park Chung-Hyun
Lee Byung-Hee
Lee Byung-Sang
Lee Kee-Heon
Kim Hyun-Ju
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Abstract
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Background: A combined spinal-epidural anesthesia (CSE) may increase the risk of epidurally injected local anesthetics spreading into subarachnoid space through the dural hole. Since the lateral holes of the epidural catheter has the potential risk of leak through the dural puncture into the subarachnoid space.
Methods: Fifty patients (ASA I or II) undergoing elective (lower extremity, lower abdominal and urologic) surgery of short duration were randomly allocated into control (group C) and dural puncture (group P) groups. In group P, the dura was punctured with a 26gauge Whitacre spinal needle and sensory blockade level was assessed by pinprick test at 5, 10, 15 and 20 minutes after epidural injection and at the end of the surgery.
Result: In group P, cranial spreads of sensory block were significantly higher levels than those of the group C at 10, 15, 20 minutes after epidural injection and at the end of the surgery (P＜0.05). Also caudal spreads of analgesia were significantlylower levels thanthose of the group C at 5, 10, 15, 20 minutes after epidural injection and at the end of the surgery (P＜0.05).
Conclusion: In a CSE, dural puncture with 26 gauge spinal needle significantly increases sensory blockadelevel by epidural injection.
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KEYWORD
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Anesthetic level, combined spinal-epidural anesthesia, dural puncture
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