A Clinical Evaluation of Epidural Anethesia - An analysis of 1,168 cases.
10.4097/kjae.1984.17.1.66
- Author:
Soon Ho NAM
1
;
Duck Mi YOON
;
Jong Rae KIM
;
Kwang Won PARK
Author Information
1. Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- MeSH:
Anesthesia;
Anesthesia, Conduction;
Anesthesia, Epidural;
Anesthesia, Spinal;
Anesthetics, Local;
Bradycardia;
Bupivacaine;
Catheters;
Epinephrine;
Headache;
Humans;
Hypotension;
Incidence;
Lidocaine;
Morphine;
Needles;
Pain, Postoperative;
Punctures;
Seizures;
Zea mays
- From:Korean Journal of Anesthesiology
1984;17(1):66-72
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
After an accidental experience of epidural anesthesia by Corning in 1885, the development of Tuohy needle, the discovery of a better local anesthetic, epidural anesthesia came into common usage in clinical anesthesia. Epidural anesthesia is more modern as a regional anesthesia than spinal anesthesia because of the low incidence of hypotension, controllability of the duration of anesthesia time, and the absence of postspinal headache. A total of 1,168 epidural anesthesia cases encountered in Severance hospital during the period of January 1, 1978 to December 31, 1982 were subjected to this clinical evaluation. The results are as follows: 1) The percentage of epidural anesthesia comprised 2.8% of total anesthesia cases. 2) The most common age groups listed in order of decreasing grequency were those in the seventh decade, third decade, and sixth decase. 3) The most common ASA physical status listed in order of decreasing frequency were those in the Class ll, Class l, Class lll. 4) The common agents of local anesthetics used were 1.5 or 2% lidocaine and sometimes bupivacaine. Additive agents such as morphine sulfate for postoperative pain control and epinephrine for prolongation of anesthesia time were used commonly. 5) The most common site of anesthesia was the sixth thoracic vertebral sensory segmental level, but a higher site for sensory anesthesia than required for the operation performed was frequently encountered. 6) The most common complications of epidural anesthesia were hypotension(21.1%) with infrequently dural puncture, traumatic tapping, bradycardia, convulsion, and catheter sequestration. In conclusion, epidural anesthesia is considered to be a safe regional anesthesia that will reduce the incidence of hypotention provided that careful control of the sensory level to be anesthetized is taekn under consideration along with the age, physical status, and operation site of the patient.
