Analysis of the Cause of Rupture of the Epidural Anesthesia Catheter

1. An overview of the current situation of anaesthetic catheter fracture.

The epidural anaesthetic catheter is used as a line for the delivery of anaesthetic, and is used in combination with the epidural puncture needle, and consists of a tube body, a guide head and a catheter joint. Epidural anaesthetic analgesics are widely used in clinical departments, and breaks occur mainly in painless delivery in obstetrics and gynecology. The incidence of ECR at home and abroad is 0.06% to 0.2% and 0.0017% to 0.04% respectively. ECR identification results responsibility is often identified as a medical side, ECR first reported abroad in the 1970s, the earliest domestic reports in 1984, nearly 30 years of literature reported more than a dozen cases of fracture. According to statistics, the total number of adverse events of national anesthesia catheters in 2018 was 255, involving Henan, Jiangsu, Zhejiang and Shandong provinces. Among them, 73 cases of catheter blockage, 54 cases of rupture, 43 cases of discount, 12 cases of pre-use fracture, 3 cases of in vitro fracture, 36 cases of internal fracture (24 cases were not removed), the fracture situation is unknown 3 cases. Of the 36 cases of internal fracture, 18 cases were difficultto inserting the catheter, clogging, indistinct, poorly positioned, bleeding pain, etc. when the catheter was placed before the anesthesia, and fractured when the body needed to be pulled out and re-placed, and 16 cases were broken when the muscle clamped and the pipe was not discounted after the anaesthetic was done.

2. The cause and analysis of the rupture of the anaesthetic catheter.

Because the anaesthetic catheter is more slender, in the process of application is prone to migration, distortion, knot wound tube body, so the product material requirements are higher. With the use of the epidural puncture needle for the edge type, needle tip slope sharp, operator is often a first-line resident or intern, due to lack of knowledge and experience, such as not in accordance with clinical practice, the repeated pull catheter, force is too large, or the patient for the maternal back tension pressure is large, local developmental malformation easy to lead to catheter rupture. In the adverse event monitoring data, there are reports of "the catheter break found that the puncture needle has a sharp roll in the front end." Surveys show that the domestic home-grown needle needle tip inner edge is basically not treated.