Advantages of the paramedian approach for lumbar epidural analgesia with catheter technique. A clinical comparison between midline and paramedian approaches.

Anaesthesia
R G BlombergS Walther

Abstract

Forty-nine patients, scheduled for transurethral resection of the prostate or a bladder neoplasm on 50 occasions, were studied. The patients were randomly allocated to one of the two methods of puncture, midline or paramedian. Technical difficulties and the occurrence of complications were recorded. The extent of sensory and motor blockade was also compared. The paramedian approach was associated with a lower frequency of technical problems compared to the midline approach. Statistically significant differences were demonstrated between the two techniques for the following factors: repeated attempts at needle insertion; difficulty in identification of the epidural space; resistance to introduction of the catheter; resistance to injection through the epidural catheter; and the production of paraesthesiae (nine patients in the midline group compared to only one patient in the paramedian group, p less than 0.01). The catheter entered a vessel at first in two patients in each group. No significant differences were demonstrated between the groups in the extent of sensory and motor blockade. The study supports the view that the paramedian approach has technical advantages over the midline approach for lumbar epidural analgesia with c...Continue Reading

References

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Citations

Jan 1, 1992·Anaesthesia·M R Stacey
Nov 29, 2007·Anesthesia and Analgesia·Anna RabinowitzOlivier Fourcade
Feb 3, 2015·Regional Anesthesia and Pain Medicine·De Q H TranRoderick J Finlayson
Mar 26, 2004·Anesthesia and Analgesia·Philipp LirkChristian Kolbitsch
Apr 12, 2007·Acta Anaesthesiologica Scandinavica·Y U AdachiS Sato
May 25, 2002·Acta Anaesthesiologica Scandinavica·Y J LimS C Lee
Nov 26, 2003·Anesthesiology·Philipp LirkBernhard Moriggl
Oct 16, 2014·The Korean Journal of Pain·Sang Pil YoonYun Suk Choi
May 1, 1993·Acta Anaesthesiologica Scandinavica·R SchererW J Kox
Oct 18, 2005·European Journal of Anaesthesiology·M LeedaJ W Van Kleef
Nov 7, 2019·Regional Anesthesia and Pain Medicine·Jinyoung BaeJin-Tae Kim
Apr 12, 2013·Der Orthopäde·J ArtnerF Lattig
Oct 21, 2016·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Anna Puigdellívol-SánchezAlberto Prats-Galino
Jul 15, 1999·Anaesthesia·S E Harries, M Stacey
Aug 10, 2011·Physical Medicine and Rehabilitation Clinics of North America·Ai Mukai, Vishal Kancherla

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