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[Epidurography in the continuous peridural anesthesia technic in geriatric surgery]
Annales De L'Anesthesiologie Francaise
|January 1, 1976
Summary
Radiographic opacification confirms correct epidural catheter placement in elderly patients receiving continuous epidural analgesia, ensuring safety and success. Malpositions are infrequent and manageable, even with age-related spinal changes.
Area of Science:
- Anesthesiology
- Radiology
- Geriatrics
Background:
- Continuous peridural analgesia is utilized for pain management in elderly patients (>75 years).
- Radiographic confirmation of epidural catheter placement enhances safety and efficacy.
- Assessing the peridural space via radiographic opacification is crucial before anesthetic injection.
Observation:
- Catheter direction was predominantly ascending (94%).
- Increased catheter length correlated with higher malposition frequency.
- Radiopaque agent injections provided specific images to verify extra-dural catheter tip placement.
Findings:
- The technique reliably confirmed extra-dural catheter placement.
- Intervertebral foramina permeability was observed in 36% of cases.
- Unilateral blocks were rare, suggesting successful epidural analgesia despite potential age-related vertebral changes.
Implications:
- Radiographic opacification is a valuable tool for ensuring safe and effective epidural analgesia in the elderly.
- The findings support the routine use of this technique to minimize complications.
- Age-related anatomical variations do not preclude successful epidural catheterization and analgesia.