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Barbara L Leighton - One of the best experts on this subject based on the ideXlab platform.
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injecting saline through the Epidural needle decreases the iv Epidural Catheter placement rate during combined spinal Epidural labour analgesia
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2003Co-Authors: Farida Gadalla, Sunghee Rhim Lee, Kue C Choi, Jill Fong, Matthew C Gomillion, Barbara L LeightonAbstract:To determine if injecting 10 mL saline before Epidural Catheter threading (pre-cannulation Epidural fluid injection) can decrease the incidence ofiv Epidural Catheter placement during combined spinal-Epidural (CSE) labour analgesia. One hundred healthy women requesting CSE labour analgesia with either fentanyl 20 μg or sufentanil 10 μg were prospectively randomized to receive either no Epidural injection (dry group,n = 50) or Epidural 10 mL saline injection (saline group,n = 50) before Epidural Catheter placement. A nylon multiport Catheter was then threaded 3–5 cm into the Epidural space and the needle was removed. We diagnosediv Catheter placement if blood was freely aspirated, if the mother became tachycardic after injection of epinephrine 15 μg, or if intracardiac air was heard (using ultrasound) after injection of air 1.5 mL. Intravenous Epidural Catheter placement occurred in one saline and ten dry group patients (P < 0.01). No complications of excessive cephalad intrathecal opioid spread (i.e., difficulty swallowing, hypoxemia, or respiratory arrest) occurred. Injecting 10 mL or saline through the Epidural needle after intrathecal opioid injection and before threading the Catheter significantly decreased accidental venous Catheter placement without any apparent increase in complications from excessive cephalad intrathecal opioid spread.
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injecting saline through the Epidural needle decreases the iv Epidural Catheter placement rate during combined spinal Epidural labour analgesia
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2003Co-Authors: Farida Gadalla, Sunghee Rhim Lee, Kue C Choi, Jill Fong, Matthew C Gomillion, Barbara L LeightonAbstract:Purpose To determine if injecting 10 mL saline before Epidural Catheter threading (pre-cannulation Epidural fluid injection) can decrease the incidence ofiv Epidural Catheter placement during combined spinal-Epidural (CSE) labour analgesia.
Kwokhan Chan - One of the best experts on this subject based on the ideXlab platform.
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bacterial colonization of Epidural Catheters used for short term postoperative analgesia microbiological examination and risk factor analysis
Anesthesiology, 2008Co-Authors: Huibih Yuan, Zhiyi Zuo, Wanmay Lin, Huichen Lee, Kwokhan ChanAbstract:Background: The authors conducted this prospective study to determine the incidence, potential routes, and risk factors of microbial colonization of Epidural Catheter used for postoperative pain control. Methods: Two-hundred five patients with Epidural analgesia for postoperative pain were studied. On removal of the Catheter, five samples were sent for culture: the infusate, a swab from inside the hub of the Epidural Catheter connector, a swab from the skin around the Catheter insertion site, the subcutaneous segment, and the tip of the Catheter. Clinical data related to the Catheter insertion, management, and general patient conditions were collected. Results: The positive culture rates for the subcutaneous and tip segments of the Catheter were 10.5% and 12.2%, respectively. The most common organism in the culture was coagulase-negative staphylococcus. There was a strong linear relationship between bacterial colonization in the skin around the Catheter insertion site and growth from the subcutaneous and tip segments of Catheter (P = 0.000). Catheter-related events at ward, blood transfusion, and positive culture from the skin at the insertion site were risk factors for bacterial colonization of Epidural Catheters. Inflammation at Catheter insertion site, Catheter indwelling time, and level of Catheter insertion were not predicators for Epidural Catheter colonization. Conclusions: The authors' results suggest that bacterial migration along the Epidural Catheter track is the most common route of Epidural Catheter colonization. Maintaining sterile skin around the Catheter insertion site will reduce colonization of the Epidural Catheter tip.
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bacterial colonization of Epidural Catheters used for short term postoperative analgesia microbiological examination and risk factor analysis
Anesthesiology, 2008Co-Authors: Huibih Yuan, Zhiyi Zuo, Wanmay Lin, Huichen Lee, Kwokhan ChanAbstract:Background: The authors conducted this prospective study to determine the incidence, potential routes, and risk factors of microbial colonization of Epidural Catheter used for postoperative pain control. Methods: Two-hundred five patients with Epidural analgesia for postoperative pain were studied. On removal of the Catheter, five samples were sent for culture: the infusate, a swab from inside the hub of the Epidural Catheter connector, a swab from the skin around the Catheter insertion site, the subcutaneous segment, and the tip of the Catheter. Clinical data related to the Catheter insertion, management, and general patient conditions were collected. Results: The positive culture rates for the subcutaneous and tip segments of the Catheter were 10.5% and 12.2%, respectively. The most common organism in the culture was coagulase-negative staphylococcus. There was a strong linear relationship between bacterial colonization in the skin around the Catheter insertion site and growth from the subcutaneous and tip segments of Catheter (P 0.000). Catheter-related events at ward, blood transfusion, and positive culture from the skin at the insertion site were risk factors for bacterial colonization of Epidural Catheters. Inflammation at Catheter insertion site, Catheter indwelling time, and level of Catheter insertion were not predicators for Epidural Catheter colonization. Conclusions: The authors’ results suggest that bacterial migration along the Epidural Catheter track is the most common route of Epidural Catheter colonization. Maintaining sterile skin around the Catheter insertion site will reduce colonization of the Epidural Catheter tip. Epidural analgesia is an effective method for postoperative pain management. However, infection may occur after the procedure. Although the reported rates of Epidural Catheter-related infection are low, 1–3 some of these infections, such as Epidural abscess, are serious and life-threatening without early diagnosis and treatment. 3–5
Farida Gadalla - One of the best experts on this subject based on the ideXlab platform.
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injecting saline through the Epidural needle decreases the iv Epidural Catheter placement rate during combined spinal Epidural labour analgesia
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2003Co-Authors: Farida Gadalla, Sunghee Rhim Lee, Kue C Choi, Jill Fong, Matthew C Gomillion, Barbara L LeightonAbstract:To determine if injecting 10 mL saline before Epidural Catheter threading (pre-cannulation Epidural fluid injection) can decrease the incidence ofiv Epidural Catheter placement during combined spinal-Epidural (CSE) labour analgesia. One hundred healthy women requesting CSE labour analgesia with either fentanyl 20 μg or sufentanil 10 μg were prospectively randomized to receive either no Epidural injection (dry group,n = 50) or Epidural 10 mL saline injection (saline group,n = 50) before Epidural Catheter placement. A nylon multiport Catheter was then threaded 3–5 cm into the Epidural space and the needle was removed. We diagnosediv Catheter placement if blood was freely aspirated, if the mother became tachycardic after injection of epinephrine 15 μg, or if intracardiac air was heard (using ultrasound) after injection of air 1.5 mL. Intravenous Epidural Catheter placement occurred in one saline and ten dry group patients (P < 0.01). No complications of excessive cephalad intrathecal opioid spread (i.e., difficulty swallowing, hypoxemia, or respiratory arrest) occurred. Injecting 10 mL or saline through the Epidural needle after intrathecal opioid injection and before threading the Catheter significantly decreased accidental venous Catheter placement without any apparent increase in complications from excessive cephalad intrathecal opioid spread.
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injecting saline through the Epidural needle decreases the iv Epidural Catheter placement rate during combined spinal Epidural labour analgesia
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2003Co-Authors: Farida Gadalla, Sunghee Rhim Lee, Kue C Choi, Jill Fong, Matthew C Gomillion, Barbara L LeightonAbstract:Purpose To determine if injecting 10 mL saline before Epidural Catheter threading (pre-cannulation Epidural fluid injection) can decrease the incidence ofiv Epidural Catheter placement during combined spinal-Epidural (CSE) labour analgesia.
Huibih Yuan - One of the best experts on this subject based on the ideXlab platform.
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bacterial colonization of Epidural Catheters used for short term postoperative analgesia microbiological examination and risk factor analysis
Anesthesiology, 2008Co-Authors: Huibih Yuan, Zhiyi Zuo, Wanmay Lin, Huichen Lee, Kwokhan ChanAbstract:Background: The authors conducted this prospective study to determine the incidence, potential routes, and risk factors of microbial colonization of Epidural Catheter used for postoperative pain control. Methods: Two-hundred five patients with Epidural analgesia for postoperative pain were studied. On removal of the Catheter, five samples were sent for culture: the infusate, a swab from inside the hub of the Epidural Catheter connector, a swab from the skin around the Catheter insertion site, the subcutaneous segment, and the tip of the Catheter. Clinical data related to the Catheter insertion, management, and general patient conditions were collected. Results: The positive culture rates for the subcutaneous and tip segments of the Catheter were 10.5% and 12.2%, respectively. The most common organism in the culture was coagulase-negative staphylococcus. There was a strong linear relationship between bacterial colonization in the skin around the Catheter insertion site and growth from the subcutaneous and tip segments of Catheter (P = 0.000). Catheter-related events at ward, blood transfusion, and positive culture from the skin at the insertion site were risk factors for bacterial colonization of Epidural Catheters. Inflammation at Catheter insertion site, Catheter indwelling time, and level of Catheter insertion were not predicators for Epidural Catheter colonization. Conclusions: The authors' results suggest that bacterial migration along the Epidural Catheter track is the most common route of Epidural Catheter colonization. Maintaining sterile skin around the Catheter insertion site will reduce colonization of the Epidural Catheter tip.
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bacterial colonization of Epidural Catheters used for short term postoperative analgesia microbiological examination and risk factor analysis
Anesthesiology, 2008Co-Authors: Huibih Yuan, Zhiyi Zuo, Wanmay Lin, Huichen Lee, Kwokhan ChanAbstract:Background: The authors conducted this prospective study to determine the incidence, potential routes, and risk factors of microbial colonization of Epidural Catheter used for postoperative pain control. Methods: Two-hundred five patients with Epidural analgesia for postoperative pain were studied. On removal of the Catheter, five samples were sent for culture: the infusate, a swab from inside the hub of the Epidural Catheter connector, a swab from the skin around the Catheter insertion site, the subcutaneous segment, and the tip of the Catheter. Clinical data related to the Catheter insertion, management, and general patient conditions were collected. Results: The positive culture rates for the subcutaneous and tip segments of the Catheter were 10.5% and 12.2%, respectively. The most common organism in the culture was coagulase-negative staphylococcus. There was a strong linear relationship between bacterial colonization in the skin around the Catheter insertion site and growth from the subcutaneous and tip segments of Catheter (P 0.000). Catheter-related events at ward, blood transfusion, and positive culture from the skin at the insertion site were risk factors for bacterial colonization of Epidural Catheters. Inflammation at Catheter insertion site, Catheter indwelling time, and level of Catheter insertion were not predicators for Epidural Catheter colonization. Conclusions: The authors’ results suggest that bacterial migration along the Epidural Catheter track is the most common route of Epidural Catheter colonization. Maintaining sterile skin around the Catheter insertion site will reduce colonization of the Epidural Catheter tip. Epidural analgesia is an effective method for postoperative pain management. However, infection may occur after the procedure. Although the reported rates of Epidural Catheter-related infection are low, 1–3 some of these infections, such as Epidural abscess, are serious and life-threatening without early diagnosis and treatment. 3–5
Matthew C Gomillion - One of the best experts on this subject based on the ideXlab platform.
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injecting saline through the Epidural needle decreases the iv Epidural Catheter placement rate during combined spinal Epidural labour analgesia
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2003Co-Authors: Farida Gadalla, Sunghee Rhim Lee, Kue C Choi, Jill Fong, Matthew C Gomillion, Barbara L LeightonAbstract:To determine if injecting 10 mL saline before Epidural Catheter threading (pre-cannulation Epidural fluid injection) can decrease the incidence ofiv Epidural Catheter placement during combined spinal-Epidural (CSE) labour analgesia. One hundred healthy women requesting CSE labour analgesia with either fentanyl 20 μg or sufentanil 10 μg were prospectively randomized to receive either no Epidural injection (dry group,n = 50) or Epidural 10 mL saline injection (saline group,n = 50) before Epidural Catheter placement. A nylon multiport Catheter was then threaded 3–5 cm into the Epidural space and the needle was removed. We diagnosediv Catheter placement if blood was freely aspirated, if the mother became tachycardic after injection of epinephrine 15 μg, or if intracardiac air was heard (using ultrasound) after injection of air 1.5 mL. Intravenous Epidural Catheter placement occurred in one saline and ten dry group patients (P < 0.01). No complications of excessive cephalad intrathecal opioid spread (i.e., difficulty swallowing, hypoxemia, or respiratory arrest) occurred. Injecting 10 mL or saline through the Epidural needle after intrathecal opioid injection and before threading the Catheter significantly decreased accidental venous Catheter placement without any apparent increase in complications from excessive cephalad intrathecal opioid spread.
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injecting saline through the Epidural needle decreases the iv Epidural Catheter placement rate during combined spinal Epidural labour analgesia
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2003Co-Authors: Farida Gadalla, Sunghee Rhim Lee, Kue C Choi, Jill Fong, Matthew C Gomillion, Barbara L LeightonAbstract:Purpose To determine if injecting 10 mL saline before Epidural Catheter threading (pre-cannulation Epidural fluid injection) can decrease the incidence ofiv Epidural Catheter placement during combined spinal-Epidural (CSE) labour analgesia.