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- Feb 20, 2011
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Where I did residency I would secure the epidural catheter using two epidural stat locks; one at the site of insertion, and another on the shoulder. I would then cover the catheter with 4 tegaderms. Where I am currently completing my OB anesthesia fellowship, the anesthesia team use the little sponge that comes in kit, which in my opinion does a pretty crappy job at securing the catheter at the insertion site, followed by one tegaderm and then tons of silk tape. No one even leaves a window. When it comes to remove the catheter approximately 50% of patient's complain of extreme pain with removal of the silk tape. Also, I notice a lot their skin is red and inflamed. I feel like the silk tape is overkill. I really would appreciate any other advice. Unfortunately, the epidural stat locks are not available at my current hospital.
Also, do you loop the epidural on the back? Where I did residency, we would frequently loop the epidural catheter on the back. I continue to do it at my new institution but I have had other attending complain that it is going to get kinked. I have had no issue with kinking. In contrast, they leave approx. 4-6 inches of catheter hanging off the shoulder and since being here (about 3 months) I have seen catheters get stretched underneath patients to the point that they need to be replaced.
Also, do you loop the epidural on the back? Where I did residency, we would frequently loop the epidural catheter on the back. I continue to do it at my new institution but I have had other attending complain that it is going to get kinked. I have had no issue with kinking. In contrast, they leave approx. 4-6 inches of catheter hanging off the shoulder and since being here (about 3 months) I have seen catheters get stretched underneath patients to the point that they need to be replaced.