• The Korean Journal of Pain
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• v.10 no.1
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• pp.73-76
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• 1997

Background : Epidural anesthesia is now accepted as a popular technique for pain relief and anesthesia. However, accidental dural puncture may occur during placement of the epidural needle. This study was undertaken to evaluate difference of the epidural depth between parturients and non-parturients. Method : Eighty non-parturients receiving epidural anesthesia were assigned to group I, and eighty parturients whose body weight had not yet increased over 15 kg from pregnancy were assigned to group II. With patients in lateral decubitus position, 18 guage Tuohy needle was punctured by approaching at $L_{3-4}$ interspace. Epidural space was identified using loss-of-resistance to air technique. Result : Epidural depth was 4.18 cm and 4.25 cm in group I and group II respectively. There was no significant statistical difference in body mass index(BMI) and ponderal index(PI) (p<0.05), nor in epidural depth between the two groups. Conclusion : Epidural needle need not be placed deeper in parturients than in nonparturients.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.64-68
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• 1997

Background : Patients mover more as their post operative pain decrease. With the increase in movement there will be a tendency for the epidural catheter to migrate out of its original position. We studied 2 methods of fixation of the epidural catheter and the changes in position as related to patient movement. Methods : Patients were divided into two groups. Patients in Group A had their epidural catheter formed with a circular loop at the (skin) exit site then directed over the right shoulder. Group B had the epidural catheter flxed with Fixomull on the exit site without forming a circular loop. At the end of the operation, 3 mg of epidural morphine was injected via indwelling epidural catheter for postoperative pain control. Epidural catheter depth was measured 24 hours later. Results : The overall rate of migration of epidural catheter was 61.9%. In Group A, number of patients whose catheter migrated over 0.5 cm was 23(69.9%) with 14 inward migration and 9 outward migration. Group B had 16(53%) patients catheters migrate over 0.5 cm, with 2 patients having inward migration and 14 outward migration. Conclusions : Although the rates of migration of epidural catheter were similar for both groups, the number of inner migration of catheter, which could result serious complications, was significantly lower in Group B than Group A. Based on our results we recommend the epidural catheter be fixed without a circular loop.