Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Real-Time Ultrasound-Assisted Thoracic Epidural Placement: A Feasibility Study of a Novel Technique

Pak, Daniel J., MD*; Gulati, Amitabh, MD

Regional Anesthesia and Pain Medicine: August 2018 - Volume 43 - Issue 6 - p 613–615
doi: 10.1097/AAP.0000000000000761
REGIONAL ANESTHESIA AND ACUTE PAIN: BRIEF TECHNICAL REPORTS

The placement of thoracic epidural catheters is complicated by the layering of the vertebral lamina. Therefore, traditional blind palpation techniques require insertion of an epidural needle with likely contact of lamina with redirections into the epidural space. We discuss a safe and consistent technique using true real-time ultrasound visualization of the needle with a paramedian sagittal oblique view to improve the consistency of placing an epidural in the thoracic spine for postoperative analgesia. Successful epidural placement was achieved in every patient. All catheters were found to be effective for use in the postoperative phase.

From the *Department of Anesthesiology, Weill Cornell Medical College, New York–Presbyterian Hospital; and

Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY.

Accepted for publication November 20, 2017.

Address correspondence to: Amitabh Gulati, MD, Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 (e-mail: gulatia@mskcc.org).

The authors have no sources of funding to declare for this article.

This work was presented in part as an abstract at the American Society of Regional Anesthesia and Pain Medicine's 42nd Annual Regional Anesthesiology and Acute Pain Medicine Meeting; April 6 to 8, 2017; San Francisco, CA.

The authors declare no conflict of interest.

Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.