Fluid through the epidural needle does not reduce complications of epidural catheter insertion

Epidural catheter insertion may be associated with blood vessel trauma or nerve root irritation. The purpose of this study was to assess whether the injection of small amounts of fluid through the Tuohy needle prior to catheter insertion reduced the incidence of these and other minor complications. Two hundred patients in labour, requesting epidural analgesia, were randomly assigned to one of three groups: Group I--the catheter was inserted without previous injection of fluid; Group II--3 ml, 1.5 per cent lidocaine hydrochloride was injected through the needle prior to catheter insertion; Group III--3 ml, saline was injected prior to catheter insertion. There were no differences among the groups in the incidence of blood vessel trauma or paraesthesiae. We conclude that there is no advantage in injecting of fluid routinely into the epidural space prior to catheter insertion.