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Glucose in epidural catheter aspirate
J H Waters1, S Ramanathan, J V Chuba
1Department of Anesthesiology, Naval Hospital, San Diego, California.
Anesthesia and Analgesia
|March 1, 1993
Summary
The glucose test for epidural fluid is unreliable for differentiating cerebrospinal fluid from local anesthetic. Glucose may be present in normal cerebrospinal fluid drainage, leading to misleading results.
Area of Science:
- Anesthesiology
- Neurosurgery
- Clinical Chemistry
Background:
- Distinguishing cerebrospinal fluid (CSF) from local anesthetic in epidural aspirates is crucial during epidural anesthesia/analgesia.
- Several methods exist, but their reliability requires further investigation.
Purpose of the Study:
- To evaluate the accuracy of the "glucose test" in identifying cerebrospinal fluid in epidural aspirates.
Main Methods:
- Aspirates from epidural catheters in 43 parturients were tested for glucose using glucose oxidase paper.
- Glucose-positive aspirates were further analyzed for prealbumin, a CSF marker, via immunoelectrophoresis.
Main Results:
- 17 of 27 cesarean section patients and 6 of 16 labor analgesia patients had glucose-positive aspirates.
- 6 of 7 glucose-positive aspirates tested positive for prealbumin.
- No patients experienced total spinal anesthesia or postdural puncture headache.
Conclusions:
- The glucose test for cerebrospinal fluid in epidural aspirates can be misleading.
- Elevated glucose levels may originate from normal cerebrospinal fluid drainage into the epidural space, not necessarily indicating a dural puncture.