Preoperative epidural catheterization under radiographic monitoring

Mitsutaka Edanaga, Masanori Yamauchi, Michiaki Yamakage

Research output: Contribution to journalArticlepeer-review

Abstract

We reviewed the indications for and features of preoperative epidural catheterization under radiographic monitoring. This technique allows easy epidural catheterization and achieves reliable effects for postoperative analgesia, reducing the burden on patients, particularly those with morbid obesity, strong transformation of spine or unilateral operations such as total knee arthroplasty or pneumectomy. Standard methods are as follows : Circled digit one the patient is placed in a prone position on the fluoroscopic table ; and Circled digit two the operator usually stands to the left of the patient. First, a 23 G, long needle is introduced for local anesthesia and to confirm depth and angle from the skin to the basal part of the spinous process. An 18 G Tuohy needle is advanced to the epidural space under real-time radiographic monitoring. It is important that the operator advances the catheter to the epidural space on the operative side (right, left or middle). Finally, confirmation is made under radiographic imaging that the catheter remains at the back of the epidural space. Preoperative epidural catheterization under radiographic monitoring is a safe, reliable, and educational method.

Original languageEnglish
Pages (from-to)488-494
Number of pages7
JournalJapanese Journal of Anesthesiology
Volume62
Issue number4
Publication statusPublished - 2013 Apr 1
Externally publishedYes

Keywords

  • Back of the epidural space
  • Preoperative epidural catheterization
  • Radiographic monitoring

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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