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Reg Anesth Pain Med · Jul 2004
Case ReportsCervical epidural analgesia via a thoracic approach using nerve stimulation guidance in an adult patient undergoing elbow surgery.
- Ban C H Tsui, Kendall Bateman, Mart Bouliane, and Brendan Finucane.
- Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, Edmonton, Alberta, Canada. btsui@ualberta.ca
- Reg Anesth Pain Med. 2004 Jul 1; 29 (4): 355-60.
ObjectiveThis case report describes the placement of a cervical epidural catheter via the thoracic approach, using nerve stimulation, in a patient undergoing elbow surgery.Case ReportAn epidural catheter was easily advanced to the C5 dermatome level from the T4-5 interspace, using nerve stimulation guidance. Successful perioperative analgesia was accomplished using an infusion of ropivacaine 0.2% with 0.05 mg/mL morphine at 4 mL/h.ConclusionsThis case report suggests that electrical stimulation may allow one to accurately position epidural catheters in the central neuraxial space to provide reliable, effective analgesia of the upper extremity. This approach might be an alternative way to deliver cervical epidural analgesia for patients undergoing upper extremity surgery.
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