Teaching practices of thoracic epidural catheterizations in different grade of anesthesia residents

Ali Alagoz; Hilal Sazak; Mehtap Tunc; Fatma Ulus; Serdar Kokulu; Polat Pehlivanoglu; Saziye Sahin

doi:10.1016/j.bjane.2014.07.010

Teaching practices of thoracic epidural catheterizations in different grade of anesthesia residents

Braz J Anesthesiol. 2016 Jan-Feb;66(1):1-6. doi: 10.1016/j.bjane.2014.07.010. Epub 2014 Oct 27.

Authors

Ali Alagoz¹, Hilal Sazak², Mehtap Tunc², Fatma Ulus², Serdar Kokulu³, Polat Pehlivanoglu², Saziye Sahin⁴

Affiliations

¹ Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey. Electronic address: mdalagoz@gmail.com.
² Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
³ Department of Anesthesiology and Reanimation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
⁴ Department of Anesthesiology, Faculty of Dentistry, Gazi University, Ankara, Turkey.

PMID: 26768922
DOI: 10.1016/j.bjane.2014.07.010

Abstract

Background and objectives: In this study, we aimed to clarify the importance of residency grade and other factors which influence the success of thoracic epidural catheterization in thoracotomy patients.

Methods: After the ethical committee approval, data were recorded retrospectively from the charts of 415 patients. All patients had given written informed consent. The thoracic epidural catheterization attempts were divided into two groups as second-third year (Group I) and fourth year (Group II) according to residency grade. We retrospectively collected demographic data, characteristics of thoracic epidural catheterization attempts, and all difficulties and complications during thoracic epidural catheterization.

Results: Overall success rate of thoracic epidural catheterization was similar between the groups. Levels of catheter placement, number and duration of thoracic epidural catheterization attempts were not different between the groups (p>0.05). Change of needle insertion level was statistically higher in Group II (p=0.008), whereas paresthesia was significantly higher in Group I (p=0.007). Dural puncture and postdural puncture headache rates were higher in Group I. Higher body mass index and level of the insertion site were significant factors for thoracic epidural catheterization failure and postoperative complication rate and those were independence from residents' experience (p<0.001, 0.005).

Conclusion: Body mass index and level of insertion site were significant on thoracic epidural catheterization failure and postoperative complication rate. We think that residents' grade is not a significant factor in terms overall success rate of thoracic epidural catheterization, but it is important for outcome of these procedures.

Keywords: Cateterismo epidural torácico; Complications; Complicações; Failure rate; Residency training; Taxa de falha; Thoracic epidural catheterization; Treinamento em residência.

MeSH terms

Adult
Aged
Anesthesia, Epidural / methods*
Anesthesiology / education*
Body Mass Index
Catheterization / methods*
Female
Humans
Internship and Residency*
Male
Middle Aged
Post-Dural Puncture Headache / epidemiology
Postoperative Complications / epidemiology
Retrospective Studies
Thoracic Vertebrae
Thoracotomy / methods
Treatment Outcome