Abstract：
OBJECTIVE: To determine the frequency of appropriate epidural catheter-incision congruency in adult patients undergoing major abdominal surgeries, as well as the frequency of ineffective postoperative analgesia with continuous epidural infusion, side effects, and complications of epidural insertion and epidural catheter infusion.
METHODS: Observational study. Place and Duration of the Study: Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan, from September to November 2022.
METHODS: All adult patients who underwent elective major abdominal surgery under general anaesthesia with epidural analgesia were included in this study. Data were collected by chart review of the patients enrolled in Acute Pain Service for the study period. Intraoperative anaesthesia form, epidural infusion form and all records of acute pain service for the postoperative period were reviewed and recorded.
RESULTS: One hundred and eighty-two patients were included in this study. The epidural catheter was inserted congruent to the surgical incision i.e. T10-T11 level or above in 43 (23.6%) patients only. In the postoperative period, overall effective epidural analgesia was observed in 79 (43.4%) of the patients. Motor block in lower limbs was observed in 66 (36.26%) of patients in the immediate postoperative period.
CONCLUSIONS: The present study shows appropriate epidural catheter-incision congruency in only 23.6% of the patients. This could be one of the common reasons for ineffective postoperative pain relief via epidural analgesia in 56.6% of patients.
BACKGROUND: Epidural catheter insertion site, Major abdominal surgeries, Postoperative analgesia.
METHODS: Observational study. Place and Duration of the Study: Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan, from September to November 2022.
METHODS: All adult patients who underwent elective major abdominal surgery under general anaesthesia with epidural analgesia were included in this study. Data were collected by chart review of the patients enrolled in Acute Pain Service for the study period. Intraoperative anaesthesia form, epidural infusion form and all records of acute pain service for the postoperative period were reviewed and recorded.
RESULTS: One hundred and eighty-two patients were included in this study. The epidural catheter was inserted congruent to the surgical incision i.e. T10-T11 level or above in 43 (23.6%) patients only. In the postoperative period, overall effective epidural analgesia was observed in 79 (43.4%) of the patients. Motor block in lower limbs was observed in 66 (36.26%) of patients in the immediate postoperative period.
CONCLUSIONS: The present study shows appropriate epidural catheter-incision congruency in only 23.6% of the patients. This could be one of the common reasons for ineffective postoperative pain relief via epidural analgesia in 56.6% of patients.
BACKGROUND: Epidural catheter insertion site, Major abdominal surgeries, Postoperative analgesia.
摘要：
目的：确定在接受大型腹部手术的成年患者中适当的硬膜外导管切口一致性的频率，以及连续硬膜外输注术后镇痛无效的频率，副作用,硬膜外插入和硬膜外导管输注的并发症。
方法：观察性研究。研究的地点和持续时间：麻醉科，阿加汗大学医院，卡拉奇,巴基斯坦,2022年9月至11月。
方法：所有在全麻下行择期腹部大手术并硬膜外镇痛的成年患者均纳入本研究。通过对在研究期间参加急性疼痛服务的患者的图表回顾收集数据。术中麻醉形式，回顾并记录术后硬膜外输注表和所有急性疼痛服务记录。
结果：本研究纳入了182例患者。仅43例（23.6％）患者将硬膜外导管插入与手术切口一致，即T10-T11水平或以上。在术后期间，79例(43.4%)患者的硬膜外镇痛总体有效.术后即刻观察到66例（36.26％）患者下肢运动阻滞。
结论：本研究仅在23.6%的患者中显示出适当的硬膜外导管切口一致性。这可能是56.6％的患者通过硬膜外镇痛有效缓解术后疼痛的常见原因之一。
背景：硬膜外导管插入部位，大型腹部手术,术后镇痛。
方法：观察性研究。研究的地点和持续时间：麻醉科，阿加汗大学医院，卡拉奇,巴基斯坦,2022年9月至11月。
方法：所有在全麻下行择期腹部大手术并硬膜外镇痛的成年患者均纳入本研究。通过对在研究期间参加急性疼痛服务的患者的图表回顾收集数据。术中麻醉形式，回顾并记录术后硬膜外输注表和所有急性疼痛服务记录。
结果：本研究纳入了182例患者。仅43例（23.6％）患者将硬膜外导管插入与手术切口一致，即T10-T11水平或以上。在术后期间，79例(43.4%)患者的硬膜外镇痛总体有效.术后即刻观察到66例（36.26％）患者下肢运动阻滞。
结论：本研究仅在23.6%的患者中显示出适当的硬膜外导管切口一致性。这可能是56.6％的患者通过硬膜外镇痛有效缓解术后疼痛的常见原因之一。
背景：硬膜外导管插入部位，大型腹部手术,术后镇痛。
