Highlights
- •In vitro study of pressure and diffusion through open- vs. closed-end catheters.
- •At high delivery rates closed-end catheters had no benefits vs. open-end catheters.
- •Observed peak pressure of a closed-end catheter might trigger an occlusion alarm.
- •The highest pressures were noted with a closed-end catheter at high delivery rates.
Abstract
Background
Epidural catheter design may impact injection pressure and analgesic outcomes under
programmed intermittent epidural bolus regimens. This in vitro study aimed to compare
the injection pressure and dye diffusion between open-end and closed-end catheters
at varying delivery rates.
Methods
The injection pressure and dye diffusion distance and area were measured at five delivery
rates (120, 240, 360, 480, and 600 mL/h) through three epidural catheters (OE-3, open-end,
three lateral ports; CE-3, closed-end, three lateral ports; OE-0, open-end, single
port). A two-way analysis of variance with the Bonferroni post hoc test was applied
for comparisons between the catheter groups and delivery rates.
Results
Forty-five pressure tests and 45 dye diffusion measurements were performed. The peak
pressure was significantly higher with the closed-end catheter at 240, 360, 480, and
600 mL/h delivery rates (P<0.025). The diffusion distance was shorter at all delivery rates (P<0.001). At 360 mL/h, the diffusion area was larger with CE-3 than with OE-0 catheters,
but at 600 mL/h it was smaller with CE-3 than with OE-3 catheters (CE-3 vs. OE-0 at
360 mL/h, P<0.025; CE-3 vs. OE-3 at 600 mL/h, P<0.025).
Conclusions
At high delivery rates (>360 mL/h), the closed-end catheter had no advantages over
the open-end catheters in diffusion distance or area. When using a close-ended catheter
and high delivery rates, the peak pressure generated might trigger the occlusion alarm.
Keywords
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Article info
Publication history
Published online: January 12, 2022
Accepted:
January 5,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
