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Subjective Experiences of Anesthesiologists Undergoing Epidural Anesthesia
  1. Richard Hetherington, D.O.*,
  2. Rom A. Stevens, M.D.,
  3. Lee J. White, M.D.*,
  4. Loren Spitzer, C.R.N.A. and
  5. Steven Koppel, M.D.
  1. *From the Departments of Anesthesiology, Georgetown University School of Medicine, Washington, D.C.
  2. Uniformed Services University of the Health Sciences, Bethesda, Maryland
  3. National Naval Medical Center, Bethesda, Maryland
  1. Reprint requests: Dr. Rom A. Stevens, 1844-West Brantwood Court, Milwaukee, WI 53209.

Abstract

Background and Objectives This study reports subjective experiences of nine anesthesiologists undergoing three consecutive epidural anesthetics.

Methods Eight anesthesiologists and one nurse anesthetist, all ASA physical status 1, underwent three lumbar epidural anesthetics as part of another study. Epidural catheters were inserted via a 17-gauge Tuohy needle without sedation after local anesthesia with pH adjusted lidocaine at the second, third, or fourth lumbar interspace. Three local anesthetics (2% lidocaine HCl, 3% chloroprocaine HCl, and 0.75% bupivacaine HCl) were administered each separated by at least 48 hours. The local anesthetic was incrementally injected via the epidural catheter to achieve at least a T-1 dermatome level of analgesia. Each subject completed a written questionnaire at the end of the study regarding their experience.

Results Most of the subjects (7 of 9) had no prior epidural anesthesia. Eight of nine subjects experienced at least one paresthesia during catheter insertion; this was uniformly described as a “poorly localized burning sensation,” radiating to the hip or leg. All subjects reported difficulty taking a deep breath and coughing with a T-1 level of analgesia. Eight of nine subjects reported dysphoria during lidocaine epidural anesthesia. Eight of nine subjects reported moderate back pain after dissipation of chloroprocaine epidural anesthesia.

Conclusions All volunteers stated that they would change their anesthetic practice as a result of participation in this study. They believed that having experienced an epidural anesthetic made them better qualified to prepare patients for this anesthetic technique.

  • anesthetic technique
  • epidural
  • survey
  • anesthesiologist

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Footnotes

  • Presented in abstract form at the 1992 ASA Annual Meeting in New Orleans.

    This study was supported by HSETC grant 92-004.

    The opinions expressed herein represent the personal views of the authors and do not represent official policy of the Navy Medical Department of the Department of Defense.