1. Ensino da prática de cateterismo epidural torácico em diferentes anos de residência em anestesia
- Author
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Mehtap Tunç, Ali Alagöz, Hilal Sazak, Fatma Ulus, Polat Pehlivanoglu, Saziye Sahin, and Serdar Kokulu
- Subjects
Adult ,Anesthesia, Epidural ,Male ,medicine.medical_specialty ,Complications ,Post-dural-puncture headache ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Thoracic Vertebrae ,Body Mass Index ,Catheterization ,lcsh:RD78.3-87.3 ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Failure rate ,Anesthesiology ,030202 anesthesiology ,Informed consent ,medicine ,Thoracic epidural catheterization ,Humans ,Thoracotomy ,Aged ,Retrospective Studies ,Cateterismo epidural torácico ,business.industry ,Residency training ,Internship and Residency ,Postoperative complication ,Retrospective cohort study ,General Medicine ,Middle Aged ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,lcsh:Anesthesiology ,Anesthesia ,Thoracic vertebrae ,Female ,Treinamento em residência ,Post-Dural Puncture Headache ,medicine.symptom ,business ,Body mass index ,Taxa de falha ,Complicações - 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 0,05). A alteração do nível de inserção da agulha foi estatisticamente maior no Grupo II (p = 0,008), enquanto que a parestesia foi significativamente maior no Grupo I (p = 0,007). As taxas de cefaléia durante e após punção dural foram maiores no Grupo I. Um índice de massa corporal (IMC) maior e o nível do local de inserção foram fatores significativos para o fracasso do CET e para as taxas de complicações no pós-operatório, mas independentes da experiência dos residentes (p
- Published
- 2016