Unique method for removal of knotted lumbar epidural catheter: A case report

BACKGROUND Combined spinal-epidural(CSE)anesthesia is the preferred anesthesia method for cesarean delivery.The use of an epidural catheter is essential for administering additional drugs intraoperatively and managing postoperative pain.However,the insertion of epidural catheters is associated with various complications,such as total spinal anesthesia,symptoms indicative of spinal nerve root irritation,and challenges in epidural catheter removal.CASE SUMMARY We present a case report of a challenging epidural catheter removal due to knotting.The lumbar computed tomography scan results revealed that the catheter formed a tight knot in the epidural space.We used a novel extubation method and successfully removed the catheter.CONCLUSION The operator can use opposite forces to"spiral"apart the spinal joints by positioning the patient's body in a specific position.The findings indicate that,when combined with imaging examination results,this method is effective for the removal of epidural catheters.

Management of a Retained Epidural Catheter in a Pregnant Patient: A Case Report and Review of Literature

Background: Epidural anesthesia is an effective intervention to treat labor pain and provide analgesia for orthopedic procedures. A rare complication of this technique is epidural catheter retention. Case Presentation: In this case report, we present an otherwise healthy 21-year-old G2P0010 woman at 39 weeks and 3 days gestation whose anesthetic management was complicated by a symptomatic retained epidural catheter fragment. Computed tomography (CT) imaging of her spine showed the fractured catheter within her paraspinal muscles and neurosurgery recommended no surgical intervention at that time. The patient reported resolution of back pain while in the postpartum unit which she continues to endorse two weeks after discharge. Conclusion: Retained epidural catheter is a medical emergency that requires immediate imaging and neurological evaluation. While magnetic resonance imaging is typically regarded as the standard imaging modality for this complication, in epidural sets that contain metallic components, we suggest using CT to avoid the risk of thermal nerve damage. In cases where the patient does not report any acute complaints, nonsurgical management may be appropriate but close follow-up is required to monitor for catheter migration.

Catheter-Assisted Interlaminar Approach for Cervical Epidural Steroid Injection in Patient with Cervical Stenosis Caused by Ossification of Posterior Longitudinal Ligament: A Case Report

We present the case of a 64-year-old man with cervical ossification of the posterior longitudinal ligament (OPLL) experiencing chronic neck pain and radiculopathy for 6 months. A catheter-assisted interlaminar Cervical Epidural Steroid Injection (CESI) was performed under fluoroscopic guidance, targeting the affected C2-C6 levels. Significant improvement was observed after this procedure, with decreased pain scores (visual analogue scale (VAS) 8 to 2) and improved mobility. This technique not only enhances the effectiveness of CESI but also reduces the likelihood of complications such as stroke or epidural hematoma and thus provides an alternative treatment option for patients with multiple stenotic levels who are unsuitable for surgery or are unresponsive to conservative therapy such as medication or physical therapy.

Comparing Epidural Analgesia and ON-Q Infiltrating Catheters for Pain Management after Hepatic Resection

Background and Objectives: Pain control after hepatic resection presents unique challenges as subcostal incisions, rib retraction, and diaphragmatic irritation can lead to significant pain. Both epidural analgesia and ON-Q catheters have been used for postoperative pain management after hepatic surgery, but to our knowledge have not been directly compared. Methods: The records of 143 patient between the ages 18 and 70 were reviewed who underwent hepatic resection by a single surgeon. Patients were categorized according to method of postoperative pain control. Average pain scores for both study groups were collected until POD#3. Results: Demographic data and the length of surgery were similar between the groups (all P > 0.05). On the day of surgery and POD#1, average pain scores for the epidural group were lower than the ON-Q group (P 0.0001 and P = 0.0008 respectively). There was no difference in pain scores on POD #2 (P = 0.2369) or POD #3 (P = 0.2289). Conclusions: Epidural analgesia provides superior pain control on the day of surgery and POD#1 when compared to On-Q catheter with IV PCA. There was no difference in pain scores on POD#2 or POD#3. Future prospective randomized trials comparing these analgesic methods will be required to further evaluate enhanced recovery after hepatic surgery.

Epidural abscess after multiple lumbar punctures for labour epidural catheter placement

Epidural catheterization is routinely used by anaesthesiologists to provide labour and post-operative analgesia. In most cases, catheter placement is without serious side effects and uneventful. However, epidural abscess is a rare complication that may result in severe morbidity. We present a case of epidural abscess after labour epidural catheter placement in a healthy 36-year-old female who presented on post-partum d 10 with complaints of fever and back pain. She was treated with intravenous antibiotics and fully recovered.

Combined Spinal Epidural Catheters for Epidural Cooling, Cerebrospinal Fluid Aspiration and Spinal Intralipid Infusion for Treatment of Spinal and Brain Injuries, Diseases and Protection

A new proposal for spinal cord and brain treatment and protection due to injuries and diseases is made herein. It is composed of two 20G nylon catheters with 6 lateral holes arranged circumferentially within 3 cm from the tip and a closed end. One catheter is inserted into the epidural space and the other catheter is inserted into the spinal space in two different lumbar interspaces using an 18G Tuohy needle 90 mm. The epidural catheter is used for cooled saline injection and infusion. The spinal catheter is used for Intralipid spinal injections and CSF aspiration. The proposal is based on the current studies on spinal cord cooling and CSF aspiration as well as on the Intralipid resuscitation properties and lipid brain protection. A study is needed to evaluate the clinical value of this combined approach.

Influence of Epidural Needle Treatment at the Heel of the Bevel on Catheter Breakage

Background: Epidural anesthesia continues to play a central role in postoperative analgesia. Epidural catheter breakage and fragment retention in the body is a complication related to epidural anesthesia. To reduce the risk of epidural catheter damage by epidural needles, needles with special changes to the heel of the bevel are commercially available. The present study aimed to assess the effectiveness of blasting and drilling treatments at the heel of the epidural needle bevel to determine which treatment is more appropriate. Methods: The epidural needles with blasting, drilling, or no treatment to the heel of the bevel were prepared. The catheter was pulled out from the tip of the epidural needle, folded back 180?, and then pulled up at a speed of 400 mm/min until it was fractured. The force needed to break the catheter (FB) was measured. Subsequently, low-density polyethylene (0.05 mm) was vertically penetrated with the needles at a speed of 200 mm/min, and the maximum force at penetration (FP) was measured. Results: The FB values for the blasted, drilled, and control needles were 21.3, 12.23, and 6.27 N, respectively (p Conclusion: Blasting treatment is the most effective approach for the prevention of catheter rupture;however, it can increase the puncture force.

经腰部硬膜外阻滞肾脏交感神经对心肌梗死大鼠心脏功能及血清炎症因子的影响

目的探讨经腰部硬膜外阻滞肾脏交感神经对心肌梗死大鼠心脏功能及血清炎症因子的影响。方法将30只健康雄性Sprague Dawley大鼠按随机数字表法分为假手术组、心肌梗死组、交感神经阻滞组,每组10只。3组大鼠均采用腰段硬膜外置管。置管后,心肌梗死组和交感神经阻滞组大鼠结扎左冠状动脉前降支诱导心肌梗死,假手术组大鼠仅在左冠状动脉前降支穿线不结扎。心肌梗死术后,交感神经阻滞组大鼠经腰段硬膜外置管注射体积分数0.2%罗哌卡因50μL,每隔24 h注射1次,注射持续至术后14 d;心肌梗死组大鼠经腰段硬膜外置管注射9 g·L^(-1)氯化钠注射液50μL,每隔24 h注射1次,注射持续至术后14 d;假手术组不注射任何药物。术后14 d,3组大鼠行超声心动图检查,测量射血分数(EF)、左心室短轴缩短率(FS)和心输出量(CO);术后24 h时抽取3组大鼠颈静脉血1 mL,术后14 d时抽取3组大鼠腹主动脉血5 mL,应用酶联免疫吸附试验检测血清中去甲肾上腺素(NE)、心肌肌钙蛋白I(cTnI)、白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)水平;术后14 d,3组大鼠腹腔注射100 g·L^(-1)水合氯醛(300 mg·kg^(-1))麻醉后,打开大鼠胸腔,迅速取下心脏,应用2,3,5-三苯基氯化四氮唑染色检测大鼠心肌梗死面积,计算心肌梗死面积比例。结果术后14 d,心肌梗死组和交感神经阻滞组大鼠EF、FS、CO显著低于假手术组,交感神经阻滞组大鼠EF、FS、CO显著高于心肌梗死组(P<0.05)。心肌梗死组和交感神经阻滞组大鼠血清中cTnI水平显著高于假手术组(t=68.260、15.110,P<0.05);心肌梗死组大鼠血清中cTnI水平显著高于交感神经阻滞组(t=27.920,P<0.05)。交感神经阻滞组大鼠心肌梗死面积比例显著低于心肌梗死组(t=14.182,P<0.001)。假手术组大鼠术后24 h与术后14 d血清中NE、IL-18、IL-1β和TNF-α水平比较差异无统计学意义(P>0.05);心肌梗死组大鼠术后14 d血清中NE、IL-1β和TNF-α水平显著高于术后24 h,IL-18水平显著低于术后24 h(P<0.05);交感神经阻滞组大鼠术后14 d血清中NE、IL-18和TNF-α水平显著低于术后24 h,IL-1β水平显著高于术后24 h(P<0.05);术后24 h、14 d,心肌梗死组和交感神经阻滞组大鼠血清中NE、IL-18、IL-1β和TNF-α水平显著高于假手术组,交感神经阻滞组大鼠血清中NE、IL-18、IL-1β和TNF-α水平显著低于心肌梗死组(P<0.05)。结论经腰部硬膜外阻滞肾脏交感神经可显著降低心肌梗死大鼠血清中炎症因子及NE水平,改善心功能。

Postoperative Analgesia and Cesarean Section under General Anesthesia: Multicenter Study

Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4th post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.

硬膜外分娩镇痛产妇置管体验的质性研究

目的深入了解自然分娩产妇硬膜外阻滞置管的真实体验,旨在为临床制订针对性干预措施提供参考。方法采用目的抽样法,2022年7-8月选取于上海某三级甲等医院自然分娩并行硬膜外镇痛的12名产妇作为研究对象,进行面对面半结构式访谈,了解其对分娩镇痛及硬膜外置管的体验,采用Colaizzi七步法分析资料及提炼主题。结果硬膜外分娩镇痛产妇的麻醉置管体验包括负性体验和正性体验,同时希望提前了解硬膜外分娩镇痛相关知识。负性体验主要有:认为镇痛存在滞后性,置管前感到焦急与害怕,置管时因疼痛难以配合且无助、希望有家属陪伴,拔除导管后仍存在担心和顾虑;正性体验包括:认为使用镇痛药物后疼痛有效缓解有助于增加分娩信心、镇痛置管期间感受到医护人员的专业和关心。结论产科医护人员应关注硬膜外分娩镇痛产妇麻醉置管过程中的真实体验,及时了解其麻醉及分娩过程中的需求,并根据产妇个体情况合理选择硬膜外分娩镇痛时机和陪伴模式,以提高分娩质量。医院层面则应重视硬膜外分娩镇痛相关知识宣教,通过多种形式为孕产妇提供便捷、高效、专业的信息支持。

钢丝加强聚脲胺酯硬膜外导管在剖宫产麻醉中的应用效果

目的分析钢丝加强聚脲胺酯硬膜外导管在剖宫产麻醉中的应用效果。方法选取2021年6月—2022年12月乌鲁木齐市妇幼保健院收治的行剖宫产的200例产妇为研究对象,按麻醉干预所用导管不同分为两组,各100例。对照组采用常规聚氯乙烯硬膜外导管,研究组采用钢丝加强聚脲胺酯硬膜外导管。比较两组麻醉相关指标(麻醉起效时间、镇痛持续时间、感觉阻滞最高平面时间、无痛平面时间)、不良反应总发生率及硬膜外置管时相关情况(导管置入血管、神经根刺激症状、一次置管成功率)。结果研究组麻醉起效时间、感觉阻滞最高平面时间及无痛平面时间均短于对照组,镇痛持续时间长于对照组,差异有统计学意义(P均<0.05)。研究组不良反应总发生率为2.00%(2/100),低于对照组的14.00%(14/100),差异有统计学意义(χ^(2)=9.782,P<0.05)。研究组导管置入血管及神经根刺激症状发生率低于对照组,一次置管成功率高于对照组,差异有统计学意义(P均<0.05)。结论剖宫产产妇麻醉时应用钢丝加强聚脲胺酯硬膜外导管,有助于提高一次置管成功率,降低不良反应发生率,优化麻醉指标。

腰麻联合双管硬膜外分娩镇痛的临床效果

目的评估腰麻联合双管硬膜外分娩镇痛的效果及对母婴的影响。方法 2015年4月至2016年1月于本院要求分娩镇痛的初产妇129例,随机分为两组。D组（n=68）腰麻后双管硬膜外阻滞分娩镇痛,S组（n=61）腰麻后单管硬膜外阻滞分娩镇痛。记录镇痛前（T0）及镇痛后10min（T1）、30 min（T2）、120 min（T3）、宫口开至7~8 cm（T4）、宫口开全（T5）、第二产程用力分娩时（T6）的VAS疼痛评分,各产程时间及缩宫素使用情况,镇痛泵按压及镇痛药物使用情况,分娩方式,产时出血量,新生儿情况和镇痛不良反应。结果 T0~T4时两组VAS评分差异无统计学意义,T5、T6时D组VAS评分明显低于S组（P〈0.05）。镇痛泵有效按压次数及镇痛药物使用量两组差异无统计学意义,但镇痛泵总按压次数D组明显少于S组（P〈0.05）。各产程时间、缩宫素使用率、分娩方式、产时出血量、新生儿情况和镇痛不良反应两组差异均无统计学意义。结论腰麻联合双管硬膜外分娩镇痛效果确切,不良反应少,产妇满意度高,对母婴是安全的。

改良硬膜外导管用于分娩镇痛的临床研究

目的·探索分娩镇痛中使用改良硬膜外导管的可行性。方法·选择2018年1-8月于上海交通大学医学院附属国际和平妇幼保健院自然分娩并要求行分娩镇痛的产妇144例,随机将其分为3组;其中在硬膜外分娩镇痛中,A组产妇使用改良硬膜外导管进行硬膜外腔置管,B组产妇使用Arrow FlexTip Plus硬膜外导管置管,C组产妇(对照组)使用普通硬膜外导管置管。记录3组产妇的硬膜外血管损伤和血管内置管、神经异感、蛛网膜下腔置管、单侧阻滞、困难置管、多次置管、置管阻力消失感、拔管困难和导管损坏的发生率。采用Fisher确切概率法比较上述指标间的差异,然后用Dunnett t检验对3组间有显著差异的指标进行两两比较。同时,观察B、C组中需要使用改良硬膜外导管再次置管的病例数及统计其成功率。结果·与C组相比,A组产妇的硬膜外血管损伤和血管内置管的发生率(P=0.002)、困难置管的发生率(P=0.000)、多次置管的发生率(P=0.006)均有所下降。且与B组、C组相比,A组产妇的置管阻力消失感发生率亦有所下降(P=0.021,P=0.000)。结论·相较于普通硬膜外导管,改良硬膜外导管能有效降低硬膜外血管损伤和血管内置管、困难置管及置管阻力消失感的发生率,提高多次置管的成功率,具有潜在的临床应用价值。

预置硬膜外导管对分娩镇痛效果和母婴安全的影响

目的观察预置硬膜外导管实施分娩镇痛的效果及对母婴安全的影响。方法选择单胎、头位、足月、有镇痛需求的初产妇364例,年龄22~30岁,BMI 25~30 kg/m^2,随机分为两组:预置管组(n=180)在出现规律宫缩、宫颈接近消失后硬膜外穿刺置管,产妇自觉疼痛剧烈要求镇痛时开始镇痛;常规组(n=184)在出现规律宫缩、宫口开大1 cm后开始硬膜外穿刺置管镇痛。两组镇痛液配方均为0.075%罗哌卡因+舒芬太尼0.5μg/ml。记录分娩镇痛的有效性评分,包括镇痛开始时的VAS评分、镇痛起效时间(从产妇要求镇痛到疼痛缓解的时间)和镇痛期间最高VAS评分;分娩期间补救镇痛情况,以及产程时间、新生儿1 min和5 min Apgar评分,产间发热情况等。结果与常规组比较,预置管组镇痛开始时的VAS评分明显降低[3(2~4)分vs 5(4~5)分,P<0.05],镇痛起效时间明显缩短[(18.45±7.05)min vs (33.2±10.51)min,P<0.05],但镇痛期间最高VAS评分差异无统计学意义[4(2~6)分vs 4(2~6)分],预置管组的有效性评分明显较高[4(3~5)分vs 3(2~4)分,P<0.05]。两组产妇产程时间、出血量、镇痛泵按压次数、补救次数、产妇发热比例及新生儿Apgar评分差异无统计学意义。结论硬膜外预置管可以提高分娩镇痛的有效性,且不影响产程和母婴安全,是一种值得推广的分娩镇痛模式。

泪小管断裂吻合术留置硬膜外导管的拔管时机

目的: 探讨泪小管断裂吻合术留置硬膜外麻醉导管最佳拔管时机。方法: 选取外伤性泪小管断裂行泪小管吻合术62例62眼为观察对象,根据随机数字表法将62例患者分为A,B,C三组,A,B组各21例21眼,C组20例20眼,所有患者均接受泪小管断裂吻合术,泪道硬膜外麻醉导管拔管时间A组为术后1mo,B组为术后2mo,C组为术后3mo。比较各组患者治疗效果及手术并发症情况。结果: 术后三组患者治疗效果比较,差异均无显著性(P>0.05);与组A及组B比较,组C患者术后下泪点外翻及泪小管炎的比例显著升高,且差异具有显著性(P<0.05)。结论: 泪小管断裂吻合术采用硬膜外麻醉导管作为支撑物时术后1mo为最佳拔管时机,既保证了治疗效果,减少了并发症,又缩短了患者因留置导管带来生活不便的时间。

思维导图在防止硬膜外镇痛泵导管滑脱中的应用

目的评价思维导图在防止硬膜外镇痛泵导管滑脱中的应用效果。方法 2013年5月和7月,便利抽样法选取华中科技大学同济医学院附属荆州医院术后留置硬膜外镇痛泵的122名患者为研究对象,按住院时间的先后将其分为对照组(60例)和观察组(62例),观察组患者使用思维导图进行护理,对照组患者按常规方法进行护理,分别统计两组患者镇痛泵导管滑脱的发生率和对镇痛效果的满意率。结果观察组患者硬膜外镇痛泵导管滑脱发生率显著低于对照组,镇痛效果的满意率显著高于对照组,差异均有统计学意义(均P<0.05)。结论采用思维导图护理留置硬膜外镇痛泵的患者,可有效降低硬膜外镇痛泵导管滑脱的发生率,提高患者对镇痛效果的满意度。

钢丝加强型硬膜外导管用于骨科下肢手术中连续硬膜外麻醉的效果

目的:分析钢丝加强型硬膜外导管用于骨科下肢手术中连续硬膜外麻醉的效果。方法:选择在本院接受骨科下肢手术的患者作为研究对象,随机分为接受普通聚氯乙烯硬膜外导管硬膜外麻醉的对照组、接受钢丝加强型硬膜外导管硬膜外麻醉的观察组,每组各59例,比较两组术中血流动力学情况、术后血清学指标。结果:(1)血流动力学:观察组的低切、中切、高切全血粘度以及低切、中切、高切全血还原粘度、红细胞聚集指数均低于对照组,差异有统计学意义(P<0.05);(2)血清炎症因子和补体:血清单核细胞趋化蛋白1(MCP-1)、高迁移率族蛋白-1(HMGB-1)、皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)水平低于对照组,C3、C4水平高于对照组,差异有统计学意义(P<0.05);(3)血小板功能:观察组的血栓素B2(TXB2)、血小板颗粒膜蛋白140(GMP-140)含量低于对照组,6-酮-前列腺素F1α(6-Keto-PGF1α)含量高于对照组,差异有统计学意义(P<0.05)。结论:钢丝加强型硬膜外导管用于骨科下肢手术中连续硬膜外麻醉可以发挥更好的麻醉效果,有助于改善血液动力学和免疫功能、抑制血小板激活。

经皮硬膜外置管法建立绵羊急性颈脊髓损伤模型

目的应用经皮穿刺技术向硬膜外置入可扩张球囊导管,建立绵羊急性颈脊髓压迫性损伤模型。方法成年雄性绵羊12只,随机分为对照组(A组)、0.6mL压迫组(B组)和1mL压迫组(C组),每组4只。所有动物均使用经皮穿刺鞘管,透视下自腰骶椎板间隙将3Fr球囊导管置入硬膜外,并输送至C6/7水平。1周后B、C组动物分别以0.6和1mL容量扩张导管球囊,持续压迫颈髓1h后撤除;A组动物不作处理。各组动物均在穿刺操作及球囊扩张前后接受CT和MRI检查,计算球囊导管的椎管侵占率,并采用改良Tarlov评分评估神经功能。分别于球囊扩张后24h及48h处死每组各2只动物,取压迫节段颈髓送病理检查。结果所有动物均顺利置管。CT检查测得置管后A、B、C组椎管侵占率(%)依次为9.1±0.2、9.1±0.2和8.9±0.2。扩张球囊后B、C组椎管侵占率(%)分别增加到45.5±2.5和78.3±2.3。MRI检查提示扩张的球囊对颈髓腹侧形成压迫。置管后各组动物神经功能正常,扩张球囊后B、C组出现后肢运动减退,且与扩张容量相关。病理结果提示B、C组在球囊扩张24h后,C6/7水平脊髓灰质前角神经元数量减少,胞体缩小,白质轻度脱髓鞘,部分轴突空泡样变;压迫48h后,病理改变进一步加重。结论经皮置管技术避免了对脊髓周围正常组织的破坏,是一种能够模拟临床实际致伤机制的急性颈脊髓损伤造模方法。

不同材质硬膜外导管用于程控硬膜外脉冲注射对分娩镇痛效果的影响

目的观察不同材质硬膜外导管用于程控硬膜外脉冲注射(PIEB)对分娩镇痛效果及不良事件的影响。方法选择拟行硬膜外分娩镇痛初产妇200例,年龄24~30岁,BMI<30 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将产妇分为两组:钢丝加强型硬膜外导管组(S组)和普通塑料硬膜外导管组(N组),每组100例。两组均连接程控硬膜外脉冲注射泵行硬膜外分娩镇痛,PIEB参数一致。记录给药后2、4、8 h的VAS疼痛评分,记录单侧阻滞的发生情况及中转剖宫产的例数,记录不良事件及产妇满意度。结果给药后4、8 h,S组VAS疼痛评分明显低于N组(P<0.05)。两组单侧阻滞和中转剖宫产比例差异无统计学意义。与N组比较,S组置管阻塞、置入血管、重新穿刺比例、置管时一过性麻木比例、注药受阻比例、导管打折和拉长比例以及固定导管处渗血、拔管后出血比例明显降低(P<0.05)。S组产妇满意度明显高于N组(P<0.05)。结论加强型钢丝硬膜外导管用于PIEB能改善分娩镇痛的效果,减少分娩镇痛期间不良事件的发生,提高产妇满意度。

钢丝加强型硬膜外导管的研制与应用

目的研制具有自主知识产权的钢丝加强型硬膜外导管,用于临床,填补国内空白。方法设计并制作超微弹簧圈、外套塑胶管、导管尖端成型、印刷刻度。利用超微弹簧圈和外套塑胶管的成型技术完成钢丝加强型硬膜外导管的制作。结果临床应用效果评价结果显示,自主生产的钢丝加强型导管明显优于普通硬膜外导管。与美国ARROW公司生产的钢丝加强型硬膜外导管比较,硬膜外阻滞的各项并发症指标均无明显差异。结论采用钢丝加强型硬膜外导管可显著减少置管损伤硬膜外神经、血管的发生率,降低医疗风险,且具有明显的价格优势,值得临床推广应用。