BACKGROUND Different additives have been used to prolong regional blockade. We designed a prospective, randomized, double-blind, controlled clinical trial to evaluate the effect of dexamethasone added to bupivacaine-fentanyl on the duration of postoperative analgesia via epidural catheterization. METHODS Seventy two adult patients scheduled for elective abdominal or thoracic surgery under epi...

Background. Thoracic epidural catheters provide the best quality postoperative pain relief for major abdominal and thoracic surgical procedures, but placement is one of the most challenging procedures in the repertoire of an anesthesiologist. Most patients presenting for a procedure that would benefit from a thoracic epidural catheter have already had high resolution imaging that may be useful ...

EPIDURAL catheters are commonly used in today’s anesthetic practice, and complications are rare. However, hematomas within the spinal canal leading to compression of the spinal cord remain a major concern. In particular, anticoagulation and bleeding disorders are considered to be risk factors for hematoma formation after neuroaxial blockade. We report a case of paraplegia that developed after r...

OBJECTIVES Effective analgesia and blockade of the perioperative stress response may improve outcome and epidural analgesia plays a role in the reduction of pulmonary complications following thoracic surgery. In this study, we assessed preoperative and postoperative thoracic epidural analgesia (Preop-TEA and Postop-TEA) techniques on post-thoracotomy pain in 61 patients undergoing posterolatera...

Intubated general anesthesia with single-lung ventilation has been considered mandatory for thoracoscopic lobectomy for nonsmall cell lung cancer. Few reports of thoracoscopic lobectomy without tracheal intubation are published, using either thoracic epidural anesthesia (TEA) or intercostal blockade. The comparisons of perioperative outcomes of nonintubated thoracoscopic lobectomy using epidura...

Thoracic paravertebral block was widely practised at the beginning of the 20th century. It has enjoyed a renaissance in the past decade. This form of afferent blockade is the technique of injecting local anaesthetic into the thoracic paravertebral space. Thoracic paravertebral analgesia is mostly indicated for unilateral surgical procedures of the thorax and abdomen. Compared to the other avail...

We read with great interest the editorial by Kamming and Davies [1] regarding the choice of thoracic epidural anaesthesia in cardiac surgery. While the authors provided an interesting analysis, we believe their conclusion regarding the 50% chance of this technique’s failure warrants further comment. Kamming and Davies reported that in two large studies [2,3] ‘epidurals have failed to achieve ad...

OBJECTIVE The most recent systematic review and meta-analysis comparing the analgesic efficacy and side effects of paravertebral and epidural blockade for thoracotomy was published in 2006. Nine well-designed randomized trials with controversial results have been published since then. The present report constitutes an updated meta-analysis of this issue. SUMMARY OF BACKGROUND Thoracotomy is a...