A COMPARATIVE STUDY OF MEDIAN AND PARAMEDIAN TECHNIQUES TO IDENTIFY THE LOWER THORACIC EPIDURAL SPACE AND CATHETER INSERTION FOR UPPER ABDOMINAL SURGERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 95
Abstract
BACKGROUND Epidural is a central neuraxial blockade with various applications. The epidural space was first described by Corning in 1901. And Fidel Pages first used epidural analgesia in humans in 1921. Fidel Pages described the interspinous approach to the epidural space and reported satisfactory anaesthesia for abdominal procedures. Improvements in equipment, drugs and technique have made it a popular and versatile anaesthetic technique, with applications in Surgery, Obstetrics and Pain relief. Both single injection and catheter techniques can be used. Its versatility means it can be used as an anaesthetic, an adjuvant to general anaesthesia and for postoperative analgesia in procedures involving the lower limbs, perineum, pelvis, abdomen and thorax. This study compares the median and paramedian epidural techniques to identify the lower thoracic epidural space and catheter insertion for upper abdominal surgeries. METHODS AND MATERIALS This is a comparative, randomised, double-blinded prospective study comparing median and paramedian approaches to identify the lower thoracic epidural space and catheter insertion for upper abdominal surgeries in two groups of patients comprising of fifty patients each. The observations were analysed using Epi info software and ANOVA measure for students’ test and Chi-square test to compare the data between the two groups. RESULTS This study shows paramedian approach of identification lower thoracic epidural space has less number of attempts, less incidence of dural tap, easy insertion of catheter, less incidence of pain, less time taken to identify the epidural space and less resistance to catheter insertion than the median approach. CONCLUSION The location of epidural space in patients posted for upper abdominal surgeries was found to be easier and has lesser complication by paramedian approach when compared to median epidural approach.
Authors and Affiliations
Liyakath Raja, Pichai Lenin, Pachaimuthu Elango, Gurusamy Sivakumar, Anbu Srinivasan
Keywords
Related Articles
- EP ID EP280636
- DOI 10.14260/jemds/2017/1520
- Views 80
- Downloads 0
PERIOPERATIVE ISCHAEMIC STROKE: STRATEGIES FOR PREVENTION AND MANAGEMENT
Stroke can be a catastrophic outcome for patients undergoing non-cardiac, nonneurologic surgery and is associated with an adjusted 8-fold increase in mortality.1 One-third of those patients who survive a stroke r...
A VERY RARE CASE OF TORSION OF A NON-GRAVID UTERUS DUE TO LARGE INTRAMURAL MYOMA
Torsion of ovary especially dermoid is very common but torsion of uterus is a rare phenomenon. Torsion of gravid uterus has been reported in many journals but torsion of non-gravid uterus is rarest of the rare...
PEDICLED PERINEAL SKIN FLAP URETHROPLASTY FOR BULBAR URETHRAL STRICTURE
BACKGROUND In patients with submucous fibrosis, free skin graft, penile foreskin and Wolfe graft are useful alternatives. In patients with history of circumcision and with recurrent episodes of balanoposthitis, we used p...
SPIROMETRIC EVALUATION OF ANTENATAL WOMEN AND THEIR OUTCOME AT A TERTIARY CARE CENTRE
BACKGROUND Pregnancy represents one of the best examples of selective adaptation in terms of respiratory physiology. Understanding of the maternal pulmonary function and their precise knowledge allows the clinician to ve...
ECTOPIC HIDRADENOMA PAPILLIFERUM ASSOCIATED WITH PILOMATRICOMA - A CASE REPORT
Hidradenoma papilliferum is a rare, benign adnexal tumor considered to be of apocrine origin that occurs almost exclusively in females on the anogenital area. Ectopic or non- anogenital hidradenoma papilliferum is rar...