Subjective experiences of anesthesiologists undergoing epidural anesthesia.

Abstract

This study reports subjective experiences of nine anesthesiologists undergoing three consecutive epidural anesthetics. Eight anesthesiologists and one nurse anesthetist, all ASA physical status 1, underwent three lumbar epidural anesthetics as part of another study. Epidural catheters were inserted via a 17-gauge Tuohy needle without sedation after local anesthesia with pH adjusted lidocaine at the second, third, or fourth lumbar interspace. Three local anesthetics (2% lidocaine HCl, 3% chloroprocaine HCl, and 0.75% bupivacaine HCl) were administered each separated by at least 48 hours. The local anesthetic was incrementally injected via the epidural catheter to achieve at least a T-1 dermatome level of analgesia. Each subject completed a written questionnaire at the end of the study regarding their experience. Most of the subjects (7 of 9) had no prior epidural anesthesia. Eight of nine subjects experienced at least one paresthesia during catheter insertion; this was uniformly described as a "poorly localized burning sensation," radiating to the hip or leg. All subjects reported difficulty taking a deep breath and coughing with a T-1 level of analgesia. Eight of nine subjects reported dysphoria during lidocaine epidural anesthesia. Eight of nine subjects reported moderate back pain after dissipation of chloroprocaine epidural anesthesia. All volunteers stated that they would change their anesthetic practice as a result of participation in this study. They believed that having experienced an epidural anesthetic made them better qualified to prepare patients for this anesthetic technique.