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 76
- Downloads 0
LARGE GROUP VERSUS SMALL GROUP- A TEACHING PRINCIPLE IN MEDICAL EDUCATION
BACKGROUND Medical education is an evolving scientific field with new modifications and changes in teaching style added continuously for the betterment of medical students. Small group teaching is a new trend compared to...
GLUE FOR DENTURE- DENTURE ADHESIVE-A REVIEW
Following the loss of natural dentition the edentulous individual can be faced with a number of problems associated with wearing complete dentures. One of the most common is that of looseness of either or both...
A COMPARATIVE STUDY BETWEEN ORAL MIDAZOLAM AND NITROUS OXIDE-OXYGEN FOR DENTAL EXTRACTIONS IN PAEDIATRIC PATIENTS
BACKGROUND Fear of pain is a major deterrent to delivery of dental care in paediatric patients. Local anaesthesia delivery is one of the most frightening and painful procedure associated with highest degree of disruptive...
SKIN TAGS AND ITS ASSOCIATION WITH SYSTEMIC ILLNESSES
[b] BACKGROUND AND OBJECTIVES[/b]: Skin tags (Acrochordons) are very common benign tumor of the skin. It is seen in 25% of population, particularly in women in advancing age and in pregnancy. Skin tags are sma...
CYTOLOGICAL AND HISTOPATHOLOGICAL CORRELATION OF THYROID NODULES- A PROSPECTIVE STUDY
BACKGROUND Fine needle aspiration cytology (FNAC) has been the diagnostic procedure of choice for the initial screening of patients with thyroid swellings, the main goal of which is to distinguish nodules that require su...