A COMPARISON OF CATHETER VS NEEDLE INJECTION OF LOCAL-ANESTHETIC FOR INDUCTION OF EPIDURAL-ANESTHESIA FOR CESAREAN-SECTION

It is generally believed that bolus injections of local anesthetic thr ough an epidural needle produce a more rapid onset of blockade, but at the expense of an increased incidence and severity of hypotension, wh ereas intermittent injections through a catheter take longer to achiev e adequate anesthesia but with a lower risk of hypotension. The presen t study investigated two commonly used needle and catheter epidural in jection techniques for differences in speed of onset of surgical anest hesia and incidence and severity of hypotension. Term parturients sche duled for elective cesarean section were randomized into two groups to receive epidural anesthesia with intermittent injection either throug h the epidural needle (n = 44) or via a previously placed catheter (n = 44). The incidence and severity of hypotension was similar in the tw o groups. No significant difference was found for the time to onset of surgical anesthesia. In the absence of benefits of needle injection, incremental catheter administration of local anesthetic with its multi ple safety advantages is the technique of choice for induction of epid ural anesthesia for cesarean section.