Korean J Anesthesiol.  1984 Mar;17(1):66-72.

A Clinical Evaluation of Epidural Anethesia - An analysis of 1,168 cases

• Nam SH
• Yoon DM
• Kim JR
• Park KW

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.

MeSH Terms

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
Anesthetics, Local
Bupivacaine
Epinephrine
Lidocaine
Morphine