COMBINED END-MULTIPLE LATERAL HOLES EPIDURAL CATHETER
(20G CEMLH EPIDURAL CATHETER; ELDOR EPIDURAL CATHETER)


CEMLH epidural catheter technique

Using the epidural needle the epidural space is reached by
the loss of resistance technique or the hanging drop
technique, while the proximal opening of the epidural needle
enters the epidural space. The epidural catheter is inserted
into the epidural space through the epidural needle. An
aspiration test and a test dose are done. If it is negative
the anesthetic solution is injected gradually until the
required dose-effect is achieved. The epidural needle is
withdrawn after the epidural catheter insertion or after the
epidural catheter aspiration test and test dose. The
epidural catheter length inside the epidural space should be
3 cm. This is measured in each patient according to the
markings in the epidural needle and the epidural catheter.
After withdrawing the epidural needle the epidural catheter
is secured on the patient`s back by a plaster to prevent
pull out and kinking. Withdrawal of the epidural catheter
after anesthesia, analgesia or several post-operative days,
should be done while the patient lies on his side with
flexed feet. The epidural catheter should be withdrawn
slowly and gently. Inspection of its completeness should be
done after its withdrawal.

Local anesthetic injections

Every time a local anesthetic solution is injected through
the CEMLH epidural catheter it should be preceded by an
aspiration test and a test dose to avoid inadvertent
subarachnoid or intravascular injections of a large volume
of a local anesthetic solution into these spaces. After
performing the aspiration test and the test dose the
injections should be done gradually and slowly until
reaching the required anesthetic level.

Hazards

Do not withdraw an epidural catheter through an epidural
needle, because of danger of shearing the catheter.
After a positive aspiration test and/or test dose for
inadvertent subarachnoid placement - the epidural catheter
should be withdrawn or be treated as a spinal catheter.
After a positive aspiration test and/or test dose for
inadvertent intravascular placement - the epidural catheter
should be withdrawn, and no further injections be made
through it.
Do not insert the epidural catheter more than 3 cm inside
the epidural space, because of kink and/or malposition.
The epidural catheter does not always go at the intended
direction (cephalad or caudad).
The device is intended for short term use only, 72 hours or
less.

Caution

Federal law restricts this device to sale by, or on the
order of a physician.

CSEN Ltd