A surgically placed epidural catheter in a patient with spinal trauma

Douglas D. Seal, Rock G. Loken, R. John Hurlbert

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: To report the successful perioperative anaesthetic and analgesic management of a spinal trauma patient with a surgically placed epidural catheter. Clinical features: A 15-yr-old adolescent woman sustained an unstable spinal column injury with an incomplete neurological deficit following a high speed motor vehicle accident. She was scheduled for spinal decompression and stabilisation through a left thoracoabdominal approach. Balanced general anaesthesia was undertaken. Prior to closure, a multi-orifice epidural catheter was surgically placed under direct vision 5 cm into the anterior epidural space. The catheter was then tunnelled out through the psoas muscle and secured in place. Combined epidural-general anaesthesia was then initiated for the duration of the case using 5 ml bupivacaine 0.25% after an initial test dose of 3 ml lidocaine 1.5% with epinephrine. An infusion of bupivacaine 0.10% and fentanyl 5 μg · ml-1 at 8 ml · hr-1 using patient controlled epidural analgesia (PCEA) provided excellent postoperative pain control for four days. She had an uncomplicated postoperative course. Conclusion: A surgically placed epidural catheter provided excellent, safe, perioperative anaesthesia and analgesia in this patient with unstable spinal trauma.

Original languageEnglish (US)
Pages (from-to)170-174
Number of pages5
JournalCanadian Journal of Anaesthesia
Volume45
Issue number2
DOIs
StatePublished - Feb 1998
Externally publishedYes

Fingerprint

Catheters
Bupivacaine
Wounds and Injuries
General Anesthesia
Balanced Anesthesia
Psoas Muscles
Anesthesia and Analgesia
Epidural Space
Patient-Controlled Analgesia
Spinal Injuries
Epidural Analgesia
Epidural Anesthesia
Fentanyl
Motor Vehicles
Postoperative Pain
Lidocaine
Decompression
Epinephrine
Accidents
Analgesics

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

A surgically placed epidural catheter in a patient with spinal trauma. / Seal, Douglas D.; Loken, Rock G.; Hurlbert, R. John.

In: Canadian Journal of Anaesthesia, Vol. 45, No. 2, 02.1998, p. 170-174.

Research output: Contribution to journalArticle

Seal, Douglas D. ; Loken, Rock G. ; Hurlbert, R. John. / A surgically placed epidural catheter in a patient with spinal trauma. In: Canadian Journal of Anaesthesia. 1998 ; Vol. 45, No. 2. pp. 170-174.
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