Technical problems associated with the use of 32‐gauge and 22‐gauge spinal catheters

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Abstract
Interest in the use of continuous spinal anaesthesia (CSA) has recently increased because of the availability of new, extremely thin catheters. In this study the use of 32-gauge (G) catheters was compared with 22-G catheters in operations on the lower limb and for the administration of intrathecal morphine in the postoperative period in 42 elderly patients. CSA succeeded in 34 cases and 8 patients were anaesthetised with a single-shot spinal method. No general anaesthesia was needed. Technical problems with the subarachnoid puncture with the 19-G needle caused two failures in the 22-G group. In a group of 20 patients, there were five failures with the 32-G catheter, as opposed to one failure with the 22-G catheter in a group of 20 patients. Associated with morphine injection through the 32-G catheter, the syringe or connector was inadvertently disconnected in four cases and a tear of the catheter wall was observed in one case. Such problems did not occur with the 22-G catheter. Postdural puncture headache did not occur, and there was no difference in the incidence of patient-reported postoperative complications between the two groups. It is concluded that both the insertion and maintenance of the thin (32-G) subarachnoid catheters are associated with more technical problems than the 22-G catheter.