Intrathecal microcatheters

[Planktonmd]

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The microcatheter is back!

http://www.anesthesiology.org/pt/re...6snhbgSh6RJBbBTJ1!238297732!181195628!8091!-1

Any comments?

 

[jetproppilot]

The microcatheter is back!

http://www.anesthesiology.org/pt/re...6snhbgSh6RJBbBTJ1!238297732!181195628!8091!-1

Any comments?

Yes.

I'm very satisfied with CSE for labor analgesia.

If this regains steam, great!

Hard to beat the George Foreman set it and forget it CSE, though.

I'll let other clinicians test the water for me, and keep abreast of the safety profile before I'd consider doing it.

 

[VentdependenT]

I'm not convinced

 

[VentdependenT]

I found the 2 page editorial on peripheral nerve damage risk factors during regional anesthesia with/without-Ultrasound far more interesting.

Does less volume (20ml vs Traditional 30-40ml) or a more dilute concentration (0.125 bupivicaine/.5% lido mix) cut down on nerve damage in succeptible individuals?

It was a good smack in the face to think about sub-clinical neuropaty in MS patients. Another risk factor for peripheral nerve damage from local anesthesia.

In addition how can one distinguish between an anesthesia caused neuropathy vs a surgical caused one, post-op? I'm just gonna blame the orthopods. They deserve it 😀.

 

[Intubate]

I've got a great idea... Let's find suboptimal replacements for things that work just fine. Oh, here's one-- the banned microcatheter.

 

[Planktonmd]

I've got a great idea... Let's find suboptimal replacements for things that work just fine. Oh, here's one-- the banned microcatheter.

Well, this is what happens when people run out of research ideas.

 

[Noyac]

Study claims more technical difficulties and catheter failures. Why in the world would I want this?

The catheters that caused neurologic damage in the past had one orifice at the tip which many speculated was the cause of the injury. I am curious if this catheter has many orifices similar to the epidural catheters we currently use.

 

[florida]

I think EMG studies can distinguish exactly where an injury occured- up at the trucks of the brachial plexus or high up on the sciatic versus lower down where the surgeons are working.

 

[VentdependenT]

I think EMG studies can distinguish exactly where an injury occured- up at the trucks of the brachial plexus or high up on the sciatic versus lower down where the surgeons are working.

I'd still blame it on the surgeons. Torque, manipulation, and demand for low blood pressures despite our advice not to.

 

[pd4emergence]

The part that gets me the most about this study was the technical difficulties encountered with the microcatheters. One of them in the study broke upon removal. Just reading the article I got the picture that they seemed to be more difficult to put in than your regular epidural and that you had to be much more careful when pulling them out. They even used the paramedian approach so that they would not have so much difficulty pulling them. Just doesn't seem practical to me.