hi,
One month before on 17.11.2006 in orthopaedics OT a 108 yr male operated upon for intertrochantric fracture femur rt under epidural anaesthesia.epidural catheter was placed in L4-L5 lavel in sitting position through paramedian approach.a total of 10 cc of 2% lignocaine with adrenaline given+5 cc of .5%bupivacaine given through epidural catheter.only 5 mg of diazepam iv given.a total of 12 mg of ephedrine given iv .2 litres of RL+300 CC of fresh blood given.patient' hemodynaemic changes least.
DR.SIMANT KUMAR JHA,JUNIOR RESIDENT,DEPTT.OF ANAESTHESIA,RIMS,RANCHI,JHARKHAND,INDIA
why thoracic epidural! more local anesthetic, more problems. Lumbar epidural in this situacion is better in my opinion.Best regards
hi,
you are very right.actually it was done under lumbar epidural only.it has been wrongly written by mistake.space chosen was L4-L5 not T4-T5. i am very sorry for this.i have posted this topic as patient was 108 yr old with cardiac function compromised.
how was the intraoperative ccourse wass blood transfused can you please eleborate on the outcome,although I t certainly is very pleasent to see succh cases,shaRE YOUR EXPERIENCE WITH US ::)
blood loss was minimal as surgeon was dam good.only one unit of fresh blood used intraoperatively i.e is 300cc.when last i enquired 1 month before patient is fine leading his normal life.regarding anaesthetic technique you have to keep in mind either give epidural or combined spinal epidural if these procedures are not contraindicated in old ages like this.one more advantage of epidural anaesthesia is peripheral vasodilatation leading to lower mean arterial pressure,so less blood loss & other advantage is no abrupt fall in blood pressure,so can be given in cardiac compromised patients & old ages.thank you