Fluoroscopy-assisted epidural catheter placement: the effect of dye distribution in preoperative epidurograms on postoperative analgesia

Abstract Background Postoperative epidural analgesia provides superior postoperative at rest and with activity, compared systemic opioids. However, the impact of on morbidity and/or mortality remains controversial, because sub-optimal reliability catheters that are placed preoperatively used for pain control. The present study technique lumbar epidurography. aims to better understand possible correlation between fluoroscopic characteristics following injection contrast medium functional regarding analgesia. In this single-arm clinical trial, 70 patients, aged 50 75 years old, underwent surgical urological procedures, involving incisions up T 8 dermatome, under combined general anesthesia. At L 2 -L 3 level, space was reached using loss resistance before anesthesia induced. were threaded upwards 4–6 cm. Preoperative epidurograms then done by injecting a 3-ml Omnipaque TM (240 mg I/ml) in catheters. investigated location catheter tip relation vertebral body, extent dye spread, laterality spread (midline, right, or left), presence absence anterior spinal cord lateral image. patients followed postoperatively while infused. Results Both infusion visual analog scale (VAS) scores lower when tips ended 1 than they . As contrast’s vertical increases preoperative epidurograms, analgesic rate VAS score decrease, number dermatomes insensitive cold increases. Epidurographically right-sided showed more deficient sensations right side, mid-line left-sided Restriction posterior associated wider cold. Conclusions use epidurography may have potential advantage predicting functionality improving