Comparison of Intraoperative and Postoperative Effects of Lateral Epidural and Midline Epidural Anaesthesia in Patients Undergoing Unilateral Lower Extremity Operation.

Abstract

We aimed to compare lateral and midline epidural anaesthesia using a levobupivacaine-fentanyl combination in patients undergoing unilateral lower extremity operation for anaesthetic effects and postoperative complications. The study included 40 American Society of Anesthesiologists (ASA) I-II group patients. At the L4-5 space, an epidural catheter was placed in patients in Group 1 by directing the tip of the needle at a 45-degree angle to the operation side and in Group 2 with the needle tip in the cephalad direction. Patients in both groups were administered a combination of 10 mL 0.5% levobupivacaine and 50 μg fentanyl via the epidural catheter. Sensorial and motor block levels during the perioperative and postoperative periods and postoperative complications were recorded. The maximum level of sensory block on the operated side was found to be at the T10 (T8-T10) level in both groups, while the level of sensory block on the non-operated side was at the L2 (L3-T10) level in Group 1, and at the T10 (T8-T10) level in Group 2 (p=0.000). The motor block was more intense on the non-operated side in Group 2 than in Group 1. The postoperative motor block ended earlier in Group 1. The incidence of complication development was similar between the groups. With a shorter lasting and lower level sensorial and motor block, lateral epidural anaesthesia may be a more advantageous method than midline epidural anaesthesia.