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Local Anesthetics: Clinical Application as Epidural Anesthesia

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy

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A simple technique to assess postoperative epidural functionality.

Gregory Klar¹, Anthony M-H Ho¹, Michael McMullen¹

¹Department of Anesthesiology & Perioperative Medicine, Queen's University, Victory 2 Wing, Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.

Journal of Clinical Monitoring and Computing

|May 26, 2022

Summary

This summary is machine-generated.

An alternative method for Epidural Waveform Analysis (EWA) uses existing arterial monitoring setups to confirm epidural catheter placement. This technique is potentially less wasteful and ensures accurate needle and catheter positioning for anesthesiologists.

Keywords:

EWA Epidural Epidural analgesia Epidural failure Epidural waveform analysis

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Area of Science:

Anesthesiology
Medical Devices
Patient Monitoring

Background:

Epidural Waveform Analysis (EWA) confirms epidural needle/catheter placement using pressure transduction.
Standard EWA requires specific equipment for epidural catheter transduction.
Accurate epidural placement is crucial for effective anesthesia and pain management.

Purpose of the Study:

To describe an alternative, potentially less wasteful method for measuring Epidural Waveform Analysis (EWA).
To demonstrate how anesthesiologists can utilize existing invasive arterial blood pressure monitoring systems for EWA.
To validate a simplified technique for confirming epidural catheter tip location.

Main Methods:

Utilized a double-male connector, 3-way stopcock, and arterial pressure extension tubing.
Integrated the technique with the patient's existing arterial line setup.
Ensured meticulous sterile technique throughout the procedure.

Main Results:

Successfully measured Epidural Waveform Analysis (EWA) using the described alternative method.
Demonstrated the generation of a characteristic oscillatory waveform indicative of correct epidural placement.
Observed potential for reduced waste compared to conventional EWA setups.

Conclusions:

The described method provides a viable alternative for measuring EWA.
This technique allows for confirmation of epidural needle/catheter position.
The approach offers potential cost-effectiveness and waste reduction in clinical practice.