Objective: To describe the technical characteristics of thoracic epidural analgesia after upper abdominal surgery.
Subjects and methods: A prospective descriptive study, 50 patients aged 18 years or older, with ASA I - III, indicated upper abdominal surgery had epidural catheter placement at the thoracic interspinal space of T7 - T8 or T8 - T9. The epidural space was determined by loss of resistance technique. Failure to define the epidural space, perforation of the dura, median or paramedian line of needle insertion, distance from the skin to the epidural space, displacement or catheter occlusion during analgesia were recorded.
Results: Success rate was 98%, the epidural space were not identified in 2%, perforation of the dura in 4%. Needle insertion via median line was in 80.9% and paramedian one in 19.1%. The distance from the skin to epidural space of 4 to 5 cm, 3-4 cm and over 5 cm was 58%, 24.5% and 18.4%, respectively. Catheter was clogged immediately after placement when performing dose test was 2.04%, dislodgement of catheter when transporting patients from the operating to the recovery room and occlusion on the second day was 2.04%.
Conclusion: Catheter insertion in analgesia following upper abdominal surgery has a high success rate, when the median technique of needle insertion failed, the paramedian was an alternative. Care for the catheter must be taken during pain management.
Key words: Technical characteristics, thoracic epidural analgesia
Thoracic Epidural Anaesthesia for Upper Abdominal Surgery
