Epidural anaesthesia and anatomy
anatomy
epidural space = potential space filled with spinal nerves, blood vessels, fat and connective tissue
Passes through:
- skin/subcut tissue
- supraspinous ligament
- interspinous ligament
- ligamentum flavum
4-5cm catheter ideally
indications
Thoracic epidural -
- laparatomy
- analgesia post-rib fractures
complications
common and benign:
- nausea
- hypotension
- itching
rare:
- Local anaesthetic toxicity
- nerve damage
- abscess
- haematoma (1:200,000)
- high blocks
sources/links
https://www.bjaed.org/article/S2058-5349(22)00011-7/fulltext - see Fig 4 for where the Tuohy needle goes
https://litfl.com/thoracic-epidural-analgesia-for-chest-trauma/
https://litfl.com/spinal-epidural-abscess/
https://www.rcoa.ac.uk/patients/patient-information-resources/anaesthesia-risk/risks-associated-regional-anaesthesia/epidural