The influence of patient position on withdrawal force of thoracic epidural catheters

Anaesthesia. 2012 Jan;67(1):19-22. doi: 10.1111/j.1365-2044.2011.06913.x. Epub 2011 Oct 4.

Abstract

We investigated the forces required to remove thoracic epidural catheters to determine the effect of patient position on removal. Eighty-four patients undergoing open thoracotomy and thoracic patient-controlled epidural analgesia were enrolled. Catheterisation was performed under fluoroscopic guidance before surgery, and the patients were allocated to one of three position groups for removal: prone; sitting; and lateral. On the third postoperative day, the peak tension during withdrawal in the assigned position was measured. No differences in mean (SD) forces were found between groups: prone 1.61 (0.39) N, supine 1.62 (0.61) N and lateral 1.36 (0.56) N (p = 0.140). The withdrawal forces required to remove thoracic epidural catheters were not affected by the position. Thus, the position for removal can be determined by patient's choice and clinical judgement.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Analgesia, Epidural / instrumentation
  • Analgesia, Epidural / methods*
  • Analgesia, Patient-Controlled
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use
  • Anesthesia, Epidural / instrumentation
  • Anesthesia, Epidural / methods*
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use
  • Body Height / physiology
  • Body Mass Index
  • Bupivacaine / administration & dosage
  • Bupivacaine / therapeutic use
  • Catheterization
  • Catheters
  • Device Removal
  • Epidural Space / diagnostic imaging
  • Female
  • Fluoroscopy
  • Humans
  • Hydromorphone / administration & dosage
  • Hydromorphone / therapeutic use
  • Male
  • Middle Aged
  • Pain, Postoperative / drug therapy
  • Patient Positioning*
  • Posture / physiology*
  • Prone Position / physiology
  • Prospective Studies
  • Sample Size
  • Sex Factors
  • Thoracic Vertebrae

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Hydromorphone
  • Bupivacaine