Multi-Port vs. Single-Port Epidural

Epidural anesthesia is a widely used technique in pain management and anesthesia for surgeries, labor, and chronic pain conditions. The epidural involves injecting anesthetic agents into the epidural space around the spinal cord, providing localized pain relief by blocking nerve signals. In clinical practice, epidural catheters can come with either a multi-port or a single-port tip, and the choice between the two can impact the efficacy and distribution of the anesthetic.

A single-port epidural catheter has an opening at the end of the catheter, through which the anesthetic agent is delivered directly into the epidural space. This type of catheter is typically straightforward in its design and function, making it a common choice in many clinical settings. In contrast, multi-port epidural catheters have several small openings along the length of the catheter, allowing for a more diffuse distribution of the anesthetic agent within the epidural space. This may result in more uniform pain relief 1.

A single-port catheter delivers the anesthetic to a specific area in the epidural space. This can be beneficial when precise pain relief is required in a localized region. Additionally, the simplicity of a single opening makes the placement and positioning of the catheter relatively easy, potentially reducing the risk of complications during insertion.

A potential drawback of single-port epidurals, however, is the limited distribution of the anesthetic within the epidural space. Because the anesthetic is delivered from one opening, it may not spread as evenly as desired, particularly in larger patients or those with anatomical variations. The localized delivery of anesthetic may also result in patchy pain relief, where some areas receive less effective pain control. This can be problematic in labor anesthesia or extensive surgical procedures where broader coverage is necessary 2–5.

The decision between a multi-port and single-port epidural catheter depends largely on the specific clinical scenario, patient anatomy, and the desired outcome of the procedure. Both multi-port and single-port epidural catheters have their advantages and limitations, and the choice between them should be based on the specific needs of the patient and the clinical situation.

References

1. Epidural Anesthesia and Analgesia – NYSORA. Available at: https://www.nysora.com/topics/abdomen/epidural-anesthesia-analgesia/.

2. Jaime, F., Mandell, G. L., Vallejo, M. C. & Ramanathan, S. Uniport soft-tip, open-ended catheters versus multiport firm-tipped close-ended catheters for epidural labor analgesia: A quality assurance study. J. Clin. Anesth. (2000). doi:10.1016/S0952-8180(00)00116-1

3. Uniport Catheter vs Multiport Catheter for Laboring Patients Undergoing Epidural – Clinical Pain Advisor. Available at: https://www.clinicalpainadvisor.com/reports/uniport-multiport-catheter-laboring-patients-undergoing-epidural/.

4. D’Angelo, R., Foss, M. L. & Livesay, C. H. A comparison of multiport and uniport epidural catheters in laboring patients. Anesth. Analg. (1997). doi:10.1097/00000539-199706000-00019

5. D’Angelo, R. Multiport Versus Uniport Epidural Catheters. Anesth. Analg. (1998).

doi:10.1097/00000539-199803000-00050

6. Thaer, S. Von, McVey, J., Shelton, J. & Johnson, Q. Obesity and Anesthesia: Challenges in the Perioperative Period. Mo. Med. 121, 156 (2024)