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Tunnelling of caudal epidural catheters in infants
1Department of Anaesthesiology, Bai Jerbai Wadia Hospital for Children Acharya Donde Marg, Parel, Mumbai 400012, India.
Insights
Subcutaneous tunnelling of epidural catheters improves patient care in developing nations by preventing contamination and prolonging catheter use. This technique enhances safety and reduces complications associated with anaesthetic procedures.
Area of Science:
- Anesthesiology
- Surgical Innovation
- Global Health
Background:
- Developing countries face challenges in patient care due to working conditions.
- Standard anesthetic techniques require adaptations for resource-limited settings.
- Epidural catheter soiling by urine and feces is a common complication.
Purpose of the Study:
- To evaluate the efficacy of subcutaneous tunnelling for caudally placed epidural catheters.
- To compare the duration of catheter retention between tunnelled and untunnelled groups.
- To assess the impact of tunnelling on catheter soiling and wound healing.
Main Methods:
- A comparative study design was employed.
- Epidural catheters were placed using subcutaneous tunnelling in one group and standard insertion in the control group.
- Duration of catheter retention was the primary outcome measure.
Main Results:
- The tunnelled epidural catheter group demonstrated a significantly longer duration of catheter retention.
- Subcutaneous tunnelling effectively prevented soiling by urine and feces.
- Absence of catheter emergence at the insertion site promoted faster wound healing.
Conclusions:
- Subcutaneous tunnelling is a valuable improvization for caudally placed epidural catheters in challenging environments.
- This technique enhances patient safety by reducing contamination and prolonging catheter usability.
- The method offers a practical solution to improve anesthetic care in resource-limited settings.
Abstract:
The working conditions in the developing world necessitate the development of many adaptations and improvizations of accepted anaesthetic techniques to improve patient care. Subcutaneous tunnelling of caudally placed epidural catheters is one such improvization to prevent the soiling of the catheter by urine and faeces. This study compares the duration of retention of catheter in a group with tunnelled catheters with an untunnelled group. The absence of a catheter emerging through skin at the site of catheter insertion hastens healing thus prolonging the retention of catheter in the tunnelled group and soiling ceases to be a major problem.