EPIDURAL CATHETERS FOR OBSTETRICS - TERMINAL HOLE OR LATERAL EYES

Background and Objectives. Controversy exists over the choice of the i deal epidural catheter for obstetric use, particularly whether the cat heter should have a single terminal hole or three lateral eyes. Method s. A randomized single-blind study of 200 obstetric patients undergoin g epidural block for analgesia in labor or for cesarean delivery was u ndertaken, using either a catheter with a terminal hole or three later al eyes. The extent and quality of the block was recorded, as well as the presence of any complications. Results. The study was abandoned af ter 102 patients had been assessed, as the incidence of unsatisfactory blocks with terminal eye catheters was found to be unacceptably high (32%), when compared with the lateral eye catheters (12%) (P < .05). F our of the terminal eye catheters (8%) had to be resited compared with one of the lateral eye catheters (2%). One case of intravascular inje ction (2%) occurred through a terminal eye catheter, despite repeated negative attempts at aspiration. Conclusions. The use of terminal eye epidural catheters in our obstetric patients has led to an unacceptabl y high incidence of both unsatisfactory blocks and catheter replacemen t. Lateral eye catheters produced better results in our circumstances.