New method of epidural anesthesia in closed blunt chest injury

The thoracic epidural anesthesia is the most suitable method for the treatment of the closed blunt chest injury but there is probability of the spinal cord injuiry. The original method combining the efficiency of classic thoracic epidural anesthesia with safety and simplicity of lumbar epidural anesthesia is suggested. This method is based on the postulates of the molecular hydrokinetic theory. Two catheters ends are disposed in lumbar epidural space in distance about two inches between them. Through one catheters end the anesthetic solution and through others end the 0,9% saline are injected synchronously in equal volumes. Hydroplunger phenomenon provides the upward anesthetic solution spreading

The efficacy of thoracic epidural anesthesia for breast surgeries

Thoracic epidural anesthesia provides selective blockade for the surgical site, with diminished requirements of opioids and local anaesthetics. If the efficacy of the same is better or equivalent to general anesthesia, the adverse effects with the later can be avoided. Hence this study was conducted to know the effectiveness of thoracic epiduralanesthesia in breast surgeries using 1.5% lignocaine with adrenaline.This prospective cross-sectional study was conducted in the department of Anaesthesiology in association with the Department of Surgery at Raja Muthaiah Medical College and Hospital, Chidambaram from January 2013 to June 2014. Adult female patients aged between 18-60 years belonging to ASA class I, class II and class III undergoing breast surgeries were included in the study. Patients with bleeding diathesis and local infections were excluded from the study. A total of thirty cases were included in the study and efficacy of epidural anaesthesia was determined by monitoring vitals in the peri-operative period. Results were analysed using Statistical package for Social Sciences (SPSS) version 17.Heart rate, blood pressure (both systolic and diastolic) and mean arterial pressure were significantly different with respect to time. Mean duration of rescue analgesia was found to be 127.33±27.62 minutes. Also 10%, 23.3%, 13.3% and 6.7% of cases reported bradycardia, shivering, hypotension and nausea during the intra operative period whereas 10% of cases reported backache and nausea, each during the post-operative period.Thoracic epidural anesthesia for breast surgeries provides good analgesia with minimal amount of drugs without significant complications.