219 January 2013 E PIDURAL block has been used extensively in pediatric patients.1Epidural block reduces the need for opioid usage, improves hemodynamic stability,2 decreases the need for postoperative ventilator support,3and lowers perioperative stress levels.4 Although cephalad advancement of epidural catheters from the caudal space to the thoracic region is commonly used, blind catheter adva...

BACKGROUND Thoracic epidural anesthesia is frequently used to maintain intraoperative and postoperative analgesia. Frequently, 3 ml of local anesthetic is used as a test dose, or for intermittent epidural injection. We assessed the extent of the spread of 3 ml of contrast medium in the thoracic epidural space and attempted to identify any correlating factors affecting the epidurography. METHO...

BACKGROUND Thoracic epidural analgesia (EDA) is the gold standard for pain control after thoracotomy. However, because of its severe side effects, it is contraindicated in patients taking anticoagulant or antiplatelet drugs. In addition, some patients' anatomy can make epidural catheter insertion challenging. We therefore investigated the safety and efficacy of paravertebral block (PVB) using a...

BACKGROUND Accidental dural puncture during epidural blockade is a rare complication. Since postdural puncture headache (PDPH) is the most frequent complication, a wisely management method will also reduce the incidence of PDPH. METHODS Five patients who had inadvertent dural puncture during the epidural procedure before hip or knee arthroplasty were included in this study. After dural punctu...

BACKGROUND Reports of prevalence of spinal pain indicate the prevalence of thoracic pain in approximately 13% of the general population compared to 32% of the population with neck pain and 43% of the population with low back pain during the past year. Even though, thoracic pain is less common than neck or low back pain, the degree of disability resulting from thoracic pain disorders seems to be...

BACKGROUND AND OBJECTIVES Anesthesia for total hip arthroplasty (THA) is a challenge due to the advanced age and associated diseases of patients. The objective of this study was to evaluate whether the efficacy of the nociceptive blockade, secondary hemodynamic effects, difficulty to execute the technique, and influence in intraoperative bleeding of lumbar plexus block combined with general ane...

INTRODUCTION Spinal angiolipoma is a benign uncommon neoplasm composed of mature lipocytes admixed with abnormal blood vessels. They account for only 0.04% to 1.2% of all spinal tumors. We present a case of thoracic epidural angiolipoma treated by combining radical resection with instrumented spinal fixation, without any surgical complication. CASE PRESENTATION A 32-year-old Asian woman prese...

BACKGROUND Neck flexion has been shown to increase cranial spread of contrast agent when a small fixed volume was injected into the high thoracic epidural space. The purpose of this study was to evaluate the effect of volume of contrast medium on its distribution through the high thoracic epidural space during neck extension and flexion using the rabbit model. METHODS An epidural catheter was...

Background Epidural anesthesia is widely used for postoperative analgesia and rarely causes permanent neurological complications. We report a case of paraplegia following abdominal surgery under combined epidural/general anesthesia. Case presentation A 75-year-old woman underwent a scheduled abdominal total hysterectomy and bilateral salpingo-oophorectomy for suspected endometrial cancer. In ...

BACKGROUND Catheter-related infections are a serious complication of continuous thoracic epidural analgesia. Tunnelling catheters subcutaneously may reduce infection risk. We thus tested the hypothesis that tunnelling of thoracic epidural catheters is associated with a lower risk of catheter-related infections. METHODS Twenty-two thousand, four hundred and eleven surgical patients with contin...