Surface Landmarks in the Lateral Decubitus Position Are Unreliable for Thoracic Epidural Catheter Placement: A Case Series.

IF 0.5 A&A Practice Pub Date : 2022-12-01 DOI:10.1213/XAA.0000000000001649
Sean W Dobson, Robert S Weller, James D Turner, Christopher M Lack, Daryl S Henshaw
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引用次数: 0

Abstract

Thoracic epidurals remain the optimal method for providing postoperative analgesia after complex open abdominal and thoracic surgeries. However, they can be challenging to both place and maintain, as evidenced by a failure rate that exceeds 30%.1 Proper identification of the epidural space and accurate placement of the catheter are critical in order to deliver effective postoperative analgesia and avoid failure.2,3 This case series investigated the difficulty in correctly identifying the proper vertebral level for thoracic epidural catheter procedures when performed in the lateral decubitus position.

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侧卧位的体表标志对胸椎硬膜外导管放置不可靠:一个病例系列。
胸廓硬膜外麻醉仍然是复杂的腹部和胸廓手术后提供术后镇痛的最佳方法。然而,它们的放置和维护都具有挑战性,故障率超过30%就证明了这一点正确识别硬膜外腔和准确放置导管是提供有效的术后镇痛和避免失败的关键。2,3本病例系列研究了当侧卧位时,正确确定胸椎硬膜外导管手术的椎体水平的困难。
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A&A Practice
A&A Practice ANESTHESIOLOGY-
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期刊介绍: A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.
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