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Techniques and Indications of Thoracic Epidural Analgesia

  • H. J. Wüst
Part of the Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine book series (A+I, volume 158)

Abstract

Excellent analgesia during and after upper abdominal surgery can be obtained by a segmental epidural blockade which includes the dermatomes T5 and L3. To achieve this segmental spread with a minimal amount of local anaesthetic for both intra- und postoperative use, the placement of an epidural catheter at the midpoint of the nerve supply to the abdominal wall in the thoracic region is essential [3—5]. Many anaesthetists, however, fear damage to the spinal cord when using the thoracic approach and they prefer therefore to make their injections into the lumbar epidural space below the level of termination of the spinal cord. The experience that over 4,500 epidural anaesthetisations were performed safely in the midthoracic region at the Anaesthesia Department of the University of Düsseldorf lends support to the opinion of Dawkins et al. [4], that this notion has been exaggerated, and anaesthetists could be advised to overcome their reluctance to use a midthoracic approach to the epidural space.

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© Springer-Verlag Berlin Heidelberg 1984

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  • H. J. Wüst

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