Why do thoracic epidurals fail?A literature review on thoracic epidural failure and catheter confirmation  

作　　者：Kamal Kumar Fuhazia Horner Mohamed Aly Gopakumar S Nair Cheng Lin 

机构地区：[1]Department of Anesthesia and Perioperative Medicine,Schulich School of Medicine,Western University,London N6A 5W9,ON,Canada [2]Department of London Health Sciences,Victoria Hospital,London N6A 5W9,ON,Canada [3]Schulich School of Medicine and Dentistry,Western University,London N6A5W9,ON,Canada

出　　处：《World Journal of Critical Care Medicine》2024年第3期11-16,共6页世界重症医学杂志

摘　　要：Thoracic epidural anesthesia(TEA)has been the gold standard of perioperative analgesia in various abdominal and thoracic surgeries.However,misplaced or displaced catheters,along with other factors such as technical challenges,equipment failure,and anatomic variation,lead to a high incidence of unsatisfactory analgesia.This article aims to assess the different sources of TEA failure and strategies to validate the location of thoracic epidural catheters.A literature search of PubMed,Medline,Science Direct,and Google Scholar was done.The search results were limited to randomized controlled trials.Literature suggests techniques such as electrophysiological stimulation,epidural waveform monitoring,and x-ray epidurography for identifying thoracic epidural placement,but there is no one particular superior confirmation method;clinicians are advised to select techniques that are practical and suitable for their patients and practice environment to maximize success.

关 键 词：Thoracic epidural Failure rate PLACEMENT Electrophysiological stimulation Epidural waveform monitoring X-ray epidurography 

分 类 号：R655[医药卫生—外科学]