We opted to eliminate epidural trays from our institution and carry a Combined Spinal Epidural Tray only. We did so to achieve a greater volume discount from our vendor and to eliminate the annoyance of opening the wrong tray—i.e epidural for CSE. Noteworthy features of this tray are the inclusion of DuraprepR rather than betadine swabs, two types of LOR syringes to provide two choices rather than none, a 5cc syringe rather than a 3cc for local skin wheal, and 20cc of saline rather than 10cc. This tray includes lyophilized tetracaine for spinal anesthesia, a slip tip 3cc syringe for EREM administration, a “mismatched 25g/18g CSE needle combo for which the tray carries the vendor’s printed caution statement for their C.Y.A. We feel this combination for needles is safe and provides excellent stability and tactile feedback.
We kept the hyperbaric spinal solutions in this tray because they are so inexpensive though seldom used, added DuraprepR, and an extra large clear drape loaded with adhesive.
We use these kits sometimes for single shot PNB, and always for continuous PNB, often combined with ultrasound. The cube-shaped needle stick pad is handy for keeping the ends of unwieldy stimulating catheters tacked down and the 14 g IV catheter is used for tunneling cPNB catheters.
