Related Experiment Videos
The median approach to transsacral epidural block
Tomoki Nishiyama1, Kazuo Hanaoka, Youji Ochiai
1Surgical Center, The Institute of Medical Science, Department of Anesthesiology, The University of Tokyo, USA. nishiyam@ims.u-tokyo.ac.jp
Anesthesia and Analgesia
|September 28, 2002
Summary
A simplified median transsacral epidural block approach is feasible in adults for rectal, anal, or urethral procedures. This technique offers a viable alternative to the traditional caudal block, proving effective with no observed side effects.
Area of Science:
- Anesthesiology
- Regional Anesthesia
Background:
- Transsacral epidural block is useful for procedures in the rectal, anal, or urethral regions.
- The traditional dorsal sacral foramen approach presents technical difficulties due to its long insertion route.
Purpose of the Study:
- To investigate the simplification of transsacral epidural block using a median approach.
- To compare the median approach via S2-3 or caudal epidural space with the lateral approach.
Main Methods:
- Thirty adult patients undergoing transurethral resection of bladder tumor were included.
- A 19-gauge Tuohy needle was used for catheter placement in the S2-3 or caudal epidural space via a median approach.
- Lidocaine 2% 15 mL was administered, and anesthesia level, hemodynamics, and side effects were compared.
Main Results:
- Anesthesia success rates were 87% for transurethral resection of bladder tumor and 100% for the sacral region in both groups.
- The highest anesthesia level achieved was T8 (S2-3 group) and T9 (caudal group) within 20 minutes.
- No adverse side effects were reported during the procedure.
Conclusions:
- The median transsacral epidural approach is technically feasible in adult patients.
- This technique provides a safe and effective alternative to caudal block for procedures in the lower pelvic region.