Background and Aims Thoracic epidural analgesia improves pain relief, bowel function, patient satisfaction and accelerates recovery in patients undergoing abdominal surgeries. Effective postoperative epidural analgesia depends on inserting the catheter correctly in the epidural space. The primary aim of this study was to observe the frequency of appropriate epidural catheter insertion site in adult patients scheduled for major abdominal surgeries and secondary objectives were to observe the frequency of ineffective postoperative analgesia, side effects, and complications.
Methods This study was conducted for a period of three months (1st July to 30th September 2022), after the approval from the Ethical Review Committee. All adult patients who underwent elective major abdominal surgery under general anaesthesia with an epidural catheter placed for postoperative pain management were included in this study. Data were collected at Aga Khan University Hospital Karachi.
Results One hundred and eighty-two patients were included in this study. Ninety-six (52.75%) of patients were male. The epidural catheter was inserted congruent to the surgical incision that is at T10/T11 interspace or above in only forty-three (23.6%) patients, below T11 but till L1 in seventy-three (40.15%) of patients, and below L1 in sixty-six (36.3%) patients. In the postoperative period, overall effective epidural analgesia was observed in seventy-nine (43.4%) of patients. Regarding the side effects of epidural infusion, the motor block was observed in sixty-six (36.26%) of patients in the immediate postoperative period.
Conclusions The frequency of appropriate epidural catheter insertion was found in 23.6% of patients. The frequency of ineffective postoperative analgesia was found in 56.6% of patients.
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