Tunnelled epidural catheter

Additional kit:

Abbocath

Scalpel

18G (‘green’) needle & syringe

 

Procedure:

After insertion of epidural, withdrawn Thouhy by 1-2 cm so that it remains in patient but outside of epidural space

Small nick in skin adjacent to epidural needle, on side of which epidural catheter is to be tunnelled

Local anaesthetic using green needle in subcut plane laterally

Apply a slight curve in abbocath needle

Then local anaesthetic using abbocath

Exit at exit site of epidural catheter. Use plastic tube to apply tension to skin to help this. Do not exit too far away otherwise will struggle with dressing.

Cut off proximal wide part of abbocath

Pass epidural catheter through abbocath

Then remove abbocath

Pull back epidural to correct position

Then pull through tunnel

Glue the two skin incisions

Apply dressing

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