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Incremental spinal anaesthesia using a 32-gauge catheter.

I G Kestin1, N W Goodman

  • 1University Department of Anaesthesia, Southmead Hospital, Westbury-on-Trym, Bristol.

Anaesthesia
|February 1, 1991
PubMed
Summary

Incremental spinal anesthesia using intrathecal catheters proved effective and safe for surgeries like prostate resection and hernia repair. This technique allowed for reliable block extension without complications, offering a promising option for pain management.

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Area of Science:

  • Anesthesiology
  • Surgical Procedures
  • Pain Management

Background:

  • Spinal anesthesia is a common anesthetic technique.
  • Intrathecal catheters offer potential for dose titration and extended anesthesia.
  • Limited data exists on incremental spinal anesthesia with microcatheters.

Purpose of the Study:

  • To evaluate the safety and efficacy of incremental spinal anesthesia using a 32-gauge intrathecal catheter.
  • To determine the dose-response relationship of plain bupivacaine administered incrementally.
  • To assess the feasibility of extending spinal blocks without adverse events.

Main Methods:

  • A prospective study involving 13 male patients undergoing transurethral resection of the prostate or inguinal hernia repair.
  • Incremental administration of 0.5% plain bupivacaine via a 32-gauge intrathecal catheter.

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  • Monitoring for block success, duration, and adverse events, including cardiovascular stability and postoperative headache.

    • Main Results:

    • The spinal technique was successful in 9 out of 13 patients.
    • Dose-response curves were established in successful cases.
    • Spinal blocks were extended safely and reliably, with no reported cardiovascular instability.
    • No patients experienced postoperative headaches, and all catheters were removed intact.

    Conclusions:

    • Incremental spinal anesthesia with 32-gauge intrathecal catheters is a feasible and safe technique for selected surgical procedures.
    • The method allows for reliable dose titration and extension of the anesthetic block.
    • This approach appears to minimize the risk of postoperative headache and catheter-related complications.