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Epidural Anesthesia - Comprehensive Academic Notes

This document provides comprehensive academic notes on epidural anesthesia, detailing its technique, anatomy, advantages, and complications. It differentiates epidural from spinal anesthesia and outlines clinical applications such as obstetric analgesia and postoperative pain management. Key aspects include the drugs used, potential complications, and a comparison of features between spinal and epidural anesthesia.

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41 views3 pages

Epidural Anesthesia - Comprehensive Academic Notes

This document provides comprehensive academic notes on epidural anesthesia, detailing its technique, anatomy, advantages, and complications. It differentiates epidural from spinal anesthesia and outlines clinical applications such as obstetric analgesia and postoperative pain management. Key aspects include the drugs used, potential complications, and a comparison of features between spinal and epidural anesthesia.

Uploaded by

proficientlearningapp
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Proficient Learning APP 1

Epidural Anesthesia — Comprehensive Academic Notes

Title: Epidural Anesthesia – Technique, Advantages, and Clinical Insights

Prepared by: Department of Anesthesiology & Pain Medicine

Author: Proficient Learning App | Academic Notes Series

1. Learning Objectives

At the end of this topic, learners will be able to:

• Describe the epidural space anatomy and technique.

• Differentiate epidural from spinal anesthesia.

• Discuss clinical indications, complications, and management.

2. Introduction

Epidural anesthesia is a regional anesthesia technique involving deposition of local


anesthetic in the epidural space, producing segmental anesthesia. It allows titration
of dose and continuous analgesia via catheterization.

3. Anatomy of the Epidural Space

• Located outside the dural membrane, extending from the foramen magnum
to the sacral hiatus.

• Contains fat, veins, lymphatics, and nerve roots.

• Identified by the loss-of-resistance technique during needle insertion.

4. Technique

1. Patient positioned sitting or lateral.

2. Identify L2–L3 or L3–L4 interspace.

3. Insert Tuohy needle perpendicular to skin.

4. Detect loss of resistance to air/saline → epidural space reached.

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5. Catheter may be advanced 3–5 cm for continuous infusion.

5. Drugs Used

Drug Concentration Duration

Bupivacaine 0.25–0.5% 2–4 h

Ropivacaine 0.2–0.5% 2–4 h

Lidocaine 2% 1–2 h

Adjuvants Fentanyl, Morphine, Clonidine Prolonged action

6. Advantages

Titrable and prolonged anesthesia


Postoperative pain relief
Less hypotension than spinal
Useful in obstetric analgesia and prolonged surgeries

7. Complications

• Accidental dural puncture → headache

• Hypotension

• Infection or abscess formation

• Accidental intravascular injection → systemic toxicity

• Catheter misplacement or migration

8. Differences Between Spinal and Epidural

Feature Spinal Epidural

Injection Site Subarachnoid space Epidural space

Volume Required 2–4 mL 10–20 mL

Onset 2–5 min 10–20 min

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Feature Spinal Epidural

Catheter Use Not possible Possible

Duration Limited Adjustable

9. Clinical Applications

• Obstetric analgesia (labor pain control)

• Postoperative pain management

• Thoracic and abdominal surgeries

• Chronic pain procedures

10. References

1. Miller RD, Anesthesia, 9th Edition.

2. Morgan GE, Clinical Anesthesiology, 7th Edition.

3. Barash PG et al., Handbook of Clinical Anesthesia, 2021.

Mob: 7012881264 [email protected] 3

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