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.
Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Publication types
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Randomized Controlled Trial
MeSH terms
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Adult
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Age Factors
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Aged
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Analgesia, Epidural / instrumentation
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Analgesia, Epidural / methods*
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Analgesia, Patient-Controlled
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Analgesics, Opioid / administration & dosage
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Analgesics, Opioid / therapeutic use
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Anesthesia, Epidural / instrumentation
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Anesthesia, Epidural / methods*
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Anesthetics, Local / administration & dosage
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Anesthetics, Local / therapeutic use
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Body Height / physiology
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Body Mass Index
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Bupivacaine / administration & dosage
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Bupivacaine / therapeutic use
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Catheterization
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Catheters
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Device Removal
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Epidural Space / diagnostic imaging
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Female
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Fluoroscopy
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Humans
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Hydromorphone / administration & dosage
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Hydromorphone / therapeutic use
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Male
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Middle Aged
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Pain, Postoperative / drug therapy
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Patient Positioning*
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Posture / physiology*
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Prone Position / physiology
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Prospective Studies
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Sample Size
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Sex Factors
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Thoracic Vertebrae
Substances
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Analgesics, Opioid
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Anesthetics, Local
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Hydromorphone
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Bupivacaine