Site of placement of an epidural catheter for postoperative analgesia

Thoracic surgery
Upper lobectomy	T4/5
Mediastinal incision	T4/5
Chest injury (rib fractures T2-T8)	*
Esophagectomy (Ivor-Lewis)	T6-T7
Mid-Lower lobectomy/wedge	T5/6
Pneumonectomy	T5/6
Chest wall resection	*
Esophagectomy with abdominal incision	T7/8
Chest injury multiple rib fractures	T2-T12
Abdominal surgery
Supraumbilical incision	T7/8
Infraumbilical incision	T7/8
Supraumbilical to infraumbilical incision	T8/9 or T9/10
Gynecologic procedures with Pfannenstiel incision	L1-L2
Knee/hip replacement or osteotomy	L2-4

This table shows the vertebral level for insertion of an epidural catheter for various types of surgery, with the goal of achieving catheter-incision congruency. For further information refer to UpToDate content on continuous epidural analgesia technique.

* The epidural catheter should be placed at an interspace that represents the caudal border of approximately one third of the incision or injury. For example, if coverage from T4 to T9 is desired, the catheter is optimally placed at T5/6.

Graphic 135106 Version 1.0

خرید پکیج

Site of placement of an epidural catheter for postoperative analgesia