Spinal epidural pressure as a less-invasive monitoring of intracranial pressure: report of two cases of encephalitis

Continuous monitoring of lower thoracic epidural pressure

PURPOSE

The aim of this study was to examine whether the epidural pressure (EPIP) can be monitored for a long period of time using the continuous epidural infusion via the lower thorax.

MATERIALS AND METHODS

Twenty-one adult patients undergoing gastrointestinal surgery had an epidural catheter inserted via the lower thoracic interspace. After induction of general anesthesia, continuous infusion of local anesthetic at a rate of 4 to 5 mL/h was applied epidurally. A pressure transducer was connected to the epidural catheter and the EPIP was monitored. During surgery, changes in the EPIP were monitored at 0, 5, and 10 cm H2O of positive end-expiratory pressure (PEEP). On postoperative day 1, 2, and 3, the EPIP was measured in the supine position, the Queckenstedt test, and the 30 degrees head-up position.

RESULTS

The EPIP was monitored continuously and stably during surgery and until postoperative day 3, it increased significantly at 5 and 10 cm H2O PEEP, and increased and decreased significantly in the Queckenstedt test and the head-up position, respectively.

CONCLUSION

Continuous epidural infusion at a rate of 4 to 5 mL/h via the lower thorax allows stable monitoring of the EPIP over a long period of time.