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Lower Thoracic Epidural Block in Diaphragmatic Plication: A Case Report.

Jes Jose¹, Nagarjuna Panidapu¹, Soundarya Murgesh Kalligudd¹

¹Department of Cardiac Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Lane, Kochi, Kerala, India.

Annals of Cardiac Anaesthesia

|January 16, 2026

Summary

Lower thoracic epidural block can help manage increased intra-abdominal pressure after diaphragmatic plication surgery for acquired diaphragmatic eventration. This approach offers a potential solution for associated complications.

Keywords:

Diaphragmatic eventration diaphragmatic plication intra-abdominal hypertension thoracic epidural

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Area of Science:

Thoracic Surgery
Anesthesiology
Pulmonology

Background:

Acquired diaphragmatic eventration (DE) involves abnormal hemidiaphragm elevation due to muscle replacement.
Current treatment for symptomatic DE is minimally invasive diaphragmatic plication.

Purpose of the Study:

To describe the utility of lower thoracic epidural block for managing elevated intra-abdominal pressure (IAP) post-diaphragmatic plication.

Main Methods:

Case report detailing the application of lower thoracic epidural block.
Monitoring of intra-abdominal pressure and associated complications.

Main Results:

Lower thoracic epidural block demonstrated usefulness in managing raised IAP.
Potential reduction in complications associated with elevated IAP.

Conclusions:

Lower thoracic epidural block is a valuable adjunct in the management of patients undergoing diaphragmatic plication.
This technique may mitigate risks associated with increased IAP following DE surgery.