Continuous monitoring of lower thoracic epidural pressure

Purpose: The aim of this study was to examine whether the epidural pressure (EPIP) can be monitored for a long period of time using the continuous epi dural infusion via the lower thorax. Materials and Methods:Twenty-one adult patients undergoing gastrointestinal surgery had an epidural catheter inserted via the lower thoracic interspac e. After induction of general anesthesia, continuous infusion of local anes thetic at a rate of 4 to 5 mL/h was applied epidurally, A pressure transduc er was connected to the epidural catheter and the EPIP was monitored. Durin g surgery, changes in the EPIP were monitored at 0, 5, and 10 cm H2O of pos itive end-expiratory pressure (PEEP), On postoperative day 1, 2, and 3, the EPIP was measured in the supine position, the Queckenstedt test, and the 3 0 degrees head-up position. Results: The EPIP was monitored continuously and stably during surgery and until postoperative day 3, it increased significantly at 5 and 10 cm H2O PE EP, and increased and decreased significantly in the Queckenstedt test and the head-up position, respectively. Conclusion: Continuous epidural infusion at a rate of 4 to 5 mL/h via the l ower thorax allows stable monitoring of the EPIP over a long period of time . Copyright (C) 2000 by W.B. Saunders Company.