Real-time ultrasound guided thoracic epidural catheterization: a technical review
Thoracic epidural analgesia is known to have superior perioperative pain control over intravenous opioid analgesia in open abdominal surgery and is an essential enhanced recovery after surgery component in major abdominal surgeries. Recently, the ultrasound-guided thoracic epidural catheter placemen...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Anesthesiologists
2021-10-01
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| Series: | Anesthesia and Pain Medicine |
| Subjects: | |
| Online Access: | http://www.anesth-pain-med.org/upload/pdf/apm-21060.pdf |
| _version_ | 1797825407014141952 |
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| author | Jong-Hyuk Lee Doo-Hwan Kim Won Uk Koh |
| author_facet | Jong-Hyuk Lee Doo-Hwan Kim Won Uk Koh |
| author_sort | Jong-Hyuk Lee |
| collection | DOAJ |
| description | Thoracic epidural analgesia is known to have superior perioperative pain control over intravenous opioid analgesia in open abdominal surgery and is an essential enhanced recovery after surgery component in major abdominal surgeries. Recently, the ultrasound-guided thoracic epidural catheter placement (TECP) technique has drawn attention as an alternative for the traditional landmark palpation-based TECP or fluoroscopic-guided TECP technique due to the equipment’s improvement and increased popularity. However, only a small number of studies have introduced the advantages and usefulness of ultrasound-guided TECP. Moreover, a certain level of ultrasound-guided in-plane technique is required to perform this technique. Thus, to apply ultrasound-guided TECP correctly and reduce the likelihood of side effects and complications, the practitioner must have a thorough understanding of the anatomical region, optimal block positioning, device selection, and management. In this technical review, the authors have compared the advantages and disadvantages of ultrasound-guided TECP to traditional techniques and described its technical aspects from patient positioning, ultrasound probe selection and scanning, needle insertion under ultrasound guidance, and successful thoracic epidural catheter insertion confirmation through ultrasound imaging. Additionally, the recommended epidural catheter tip placement level with the extent of its injectate epidural spread is further described in this review in reference to a recent prospective study published by the authors. |
| first_indexed | 2024-03-13T10:53:34Z |
| format | Article |
| id | doaj.art-a36d764888454b7b98475f2ee18f0794 |
| institution | Directory Open Access Journal |
| issn | 1975-5171 2383-7977 |
| language | English |
| last_indexed | 2024-03-13T10:53:34Z |
| publishDate | 2021-10-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Anesthesia and Pain Medicine |
| spelling | doaj.art-a36d764888454b7b98475f2ee18f07942023-05-17T05:51:41ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772021-10-0116432232810.17085/apm.210601087Real-time ultrasound guided thoracic epidural catheterization: a technical reviewJong-Hyuk Lee0Doo-Hwan Kim1Won Uk Koh2 Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaThoracic epidural analgesia is known to have superior perioperative pain control over intravenous opioid analgesia in open abdominal surgery and is an essential enhanced recovery after surgery component in major abdominal surgeries. Recently, the ultrasound-guided thoracic epidural catheter placement (TECP) technique has drawn attention as an alternative for the traditional landmark palpation-based TECP or fluoroscopic-guided TECP technique due to the equipment’s improvement and increased popularity. However, only a small number of studies have introduced the advantages and usefulness of ultrasound-guided TECP. Moreover, a certain level of ultrasound-guided in-plane technique is required to perform this technique. Thus, to apply ultrasound-guided TECP correctly and reduce the likelihood of side effects and complications, the practitioner must have a thorough understanding of the anatomical region, optimal block positioning, device selection, and management. In this technical review, the authors have compared the advantages and disadvantages of ultrasound-guided TECP to traditional techniques and described its technical aspects from patient positioning, ultrasound probe selection and scanning, needle insertion under ultrasound guidance, and successful thoracic epidural catheter insertion confirmation through ultrasound imaging. Additionally, the recommended epidural catheter tip placement level with the extent of its injectate epidural spread is further described in this review in reference to a recent prospective study published by the authors.http://www.anesth-pain-med.org/upload/pdf/apm-21060.pdfcatheterizationepidural analgesiathoracic vertebraeultrasonography |
| spellingShingle | Jong-Hyuk Lee Doo-Hwan Kim Won Uk Koh Real-time ultrasound guided thoracic epidural catheterization: a technical review Anesthesia and Pain Medicine catheterization epidural analgesia thoracic vertebrae ultrasonography |
| title | Real-time ultrasound guided thoracic epidural catheterization: a technical review |
| title_full | Real-time ultrasound guided thoracic epidural catheterization: a technical review |
| title_fullStr | Real-time ultrasound guided thoracic epidural catheterization: a technical review |
| title_full_unstemmed | Real-time ultrasound guided thoracic epidural catheterization: a technical review |
| title_short | Real-time ultrasound guided thoracic epidural catheterization: a technical review |
| title_sort | real time ultrasound guided thoracic epidural catheterization a technical review |
| topic | catheterization epidural analgesia thoracic vertebrae ultrasonography |
| url | http://www.anesth-pain-med.org/upload/pdf/apm-21060.pdf |
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