Epidural Tuohy Needles Brief History

A number of innovations by Eugene Aburel, Robert Hingson, Waldo Edwards, and James Southworth, among others, attempted to prolong the single-shot epidural technique. However, Cuban anesthesiologist Manual Martinez Curbelo is credited with adapting Edward Tuohy’s continuous subarachnoid technique for the epidural space in 1947. His efforts were facilitated by an extensive knowledge of anatomy, a first-hand experience observing Tuohy at the Mayo Clinic, and the availability of 16-gauge Tuohy needles and small, gradated 3.5-French ureteral catheters, which curved as they exited the tip of the needle. Several modifications of the Tuohy needle, itself a modification of the Huber needle, have since emerged.

The epidural catheter has also evolved from its origins as a modified ureteral catheter. Several manufacturers currently use nylon blends to produce thin, kink-resistant catheters of appropriate tensile strength and stiffness. The wire-reinforced catheter represents the most recent technological advance in epidural catheter design. The addition of a circumferential stainless steel coil within a nylon or polyurethane catheter confers greater flexibility compared to standard nylon catheters and may decrease the incidence of venous cannulation, intrathecal placement, catheter migration, and paresthesias.

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