OBJECTIVE A substantial reduction in lung volumes and pulmonary function follows cardiac surgery. Pain may prevent effective breathing and coughing, and as thoracic epidural analgesia may reduce postoperative pain, we investigated the effect of epidural analgesia on pulmonary function. METHODS Fifty-four male patients, under 65 years and with an ejection fraction of more than 0.5, were random...

Solitary spinal epidural cavernous angiomas are rare lesions, especially in paediatric age group. They are infrequently considered in the differential diagnosis of spinal epidural masses in children. We report a case of solitary epidural cavernous angioma of the thoracic spine in a child presenting with acute onset of back pain and myelopathy. Magnetic resonance imaging of the thoracic spine de...

BACKGROUND Epidural anesthesia is widely used to provide pain relief, whether for surgical anesthesia, postoperative analgesia, treatment of chronic pain, or to facilitate painless childbirth. In many cases, however, the epidural catheter is inserted blindly and the indwelling catheter position is almost always uncertain. METHODS In this study, the loss-of-resistance technique was used and an...

The addition of thoracic epidural anesthesia to general anesthesia during cardiac surgery may have a beneficial effect on clinical outcome. However, epidural catheter insertion in a patient anticoagulated with heparin may increase the risk of epidural hematoma. We report a case of epidural hematoma in a 55-year-old male patient who had a thoracic epidural placed under general anesthesia precedi...

Reflex circulatory responses are chiefly governed by the integrated functions of both sympathetic and parasympathetic nervous systems at any moment. To examine how sympathetic denervation of the important effector organ, the heart, modifies such reflex responses, the authors compared circulatory responses to arterial baroreflexes, the Valsalva maneuver (VM), coughing (C), swallowing (S), and na...

Objective: Subtotal gastrectomy has been successfully performed using thoracic epidural anaesthesia alone in two high-risk surgical patients. We describe these two cases by using the Bromage’s formula to calculate the required doses for a satisfactory segmental block. Case Report: Two high-risk surgical patients were scheduled for sub-total gastrectomy. They received thoracic epidural anaesthes...

Cardiac surgery is associated with high morbidity and mortality in patients with renal, hepatic or pulmonary dysfunction, advanced age and morbid obesity. Thoracic epidural analgesia is associated with decreased morbidity in these patients. Thoracic epidural analgesia in cardiac surgery is associated with haemodynamic stability, decreased catecholamine response, good pulmonary function, early e...

BACKGROUND AND AIMS Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal ope...

Correspondence Post-thoracotomy epidural vs paravertebral analgesia Editor.-I read with interest the article by Richardson and colleagues on post-thoracotomy pain.' The authors compared thoracic paravertebral bupivacaine (bolus of 0. 5 6 followed by infusion of 0.5%) with thoracic epidural bupivacaine (bolus of 0.25% followed by infusion of 0.25%). Both groups received PCA morphine. The paraver...