Uniport soft-tip, open-ended catheters versus multiport firm-tipped close-ended catheters for epidural labor analgesia: A quality assurance study

Study Objective: To compare a multiport, firm-tipped close-ended, epidural catheter (Portex catheter) with a uniport open-ended, soft-tipped, wire-reinforced catheter (Arrow catheter) in obstetric patients. Study Design: Prospective data collection for intradepartmental quality assurance Setting: Obstetric unit in a tertiary care maternity hospital Patients: 2612 patients requesting labor analgesia. Interventions: The Arrow catheter was used in 1,352 women and the Porter catheter in 1,260 women. Measurements and Main Results: The incidence of unsatisfactory bloch were 3.3% and 4.4% with the Arrow and Porter catheters, respectively (p = 0.2). The catheter peforated the dura matter in 0.4% of cases with both catheters. The incidence of epidural venipuncture was 1.1% with the Arrow catheter and 5.7% with the Porter catheter (p = 0.0001). Paresthesias occured in 6% of cases with the Arrow catheter and 11.2% of cases with the Porter catheter (p = 0.0001). Epidural catheter reinsertion was required in fewer patients in the Arrow group than in the Porter group (4.8% vs. 7.1%; p = 0.01). Conclusions: In obstetric patients, the softer uniport Arrow catheter produces paresthesias and venipunctures less frequently than the firm multiport Porter catheter. (C) 2000 by Elsevier Science Inc.