Nylon Versus Polyurethane Epidural Catheters In Patients Undergoing Major Orthopedic Surgery

Damanhour Teaching Hospital60 enrolled

Overview

Objectives: To compare the safety and efficacy of nylon (polyamide) epidural catheter versus polyurethane epidural catheter in patients undergoing major orthopedic surgery under continuous epidural anesthesia. Background: Continuous epidural anesthesia is the most common anesthetic technique used in orthopedic surgery. However, the use of epidural catheters is associated with complications. The insertion of the catheter may be associated with intravascular or intrathecal placement, nerve root irritation, paresthesia, kinking, hematoma, or breakage during catheter removal. Patients and Methods: This was a prospective, randomized, double-blind clinical trial; carried out on 60 patients undergoing major orthopedic surgery under continuous epidural anesthesia. Patients were randomly allocated into two equal groups; group N, using Nylon catheter, and group P, using Polyurethane catheter.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

DOUBLE

Enrollment

Conditions

Epidural; Anesthesia Catheter Complications Catheter Blockage

Eligibility

Sex: ALLMin age: 21 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists (ASA) physical status ≤ II * Age from 21 to 60 years * Body Mass Index (BMI) \< 35 Exclusion Criteria: * American Society of Anesthesiologists (ASA) physical status \> II * Age \< 21 years or \> 60 years * Body Mass Index (BMI) ≥ 35 * Contraindications to regional anesthesia (including coagulopathy and infection at the injection site) * Uncooperative patients * Patients with known allergy to local anesthetics or opioids

Outcomes

Primary Outcomes

Mean and Standard deviation of Time required for epidural catheter insertion (seconds) (mean±SD)

Time interval from holding the epidural catheter by the anesthetist till removal of the Tuohy needle through the epidural catheter by the anesthetist

Time frame: 2 minutes after identifying the epidural space by loss of resistance technique

Secondary Outcomes

Mean and Standard deviation of Time required for epidural catheter to anchor with the catheter connector (seconds) (mean±SD)

Time interval from holding the epidural catheter by the anesthetist till anchoring it with the catheter connector by the anesthetist

Time frame: 2 minutes after removal of the Tuohy needle through the epidural catheter

Mean and Standard deviation of Time required for epidural catheter removal (seconds) (mean±SD)

Time interval from holding the epidural catheter by the anesthetist till removal of the epidural catheter by the anesthetist

Time frame: 2 minutes after the end of the operation

Number of participants and Rate of Catheter-related complications

Number of participants and Rate of: Catheter kink, Catheter stretch, Difficult catheter insertion, Intravascular placement, Intrathecal placement, Paresthesia, Failure (asymmetric, unilateral, no block at 30 min), Hematoma, Breakage during removal.