• Chuanbao Han, Qinhai Zhou, Zhengnian Ding, and Yanning Qian.
• Department of Anesthesiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, China. Electronic address: mzhcb@126.com.
• J Clin Anesth. 2015 Feb 1;27(1):7-11.

Study ObjectiveTo evaluate the effects of epinephrine (1:200,000) in the epidural space on the incidence of blood vessel injury by epidural catheter insertion for cesarean section.DesignProspective observational study.SettingUniversity-affiliated teaching hospital.PatientsFour hundred laboring women with singleton cephalic presentations at term who underwent cesarean section and requested continuous epidural analgesia.InterventionsPredistension of 5 mL of isotonic sodium chloride solution containing epinephrine (1:200,000) or 5 mL of isotonic sodium chloride solution through an epidural needle before catheter insertion.MeasurementsCases with bloody fluid in the epidural needle or catheter during catheter insertion, aspiration of frank blood from the epidural catheter, and blood noted in the caudal end of the epidural catheter upon removal were recorded.Main ResultsEight parturients were excluded from the analysis for technical reasons. There were no significant differences between patients in the 2 groups with respect to cases with bloody fluid in the epidural needle during catheter insertion (7.6% vs 9.8%, P = .44), the epidural catheter during catheter placement (6.0% vs 6.7%, P = .80), aspiration of frank blood in the epidural catheter (1.0% vs 1.0 %, P = .98), and blood noted in the caudal end of the epidural catheter upon removal (27.3% vs 30.4 %; P > .49).ConclusionTwenty-five micrograms of epinephrine (1:200,000) in the epidural space does not reduce the incidence of blood vessel injury induced by insertion of an epidural catheter.Copyright © 2014 Elsevier Inc. All rights reserved.

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