Thoracic Epidural Anesthesia - A PBLD

Regional Anesthesia Rounds hosted by TWH Department of Anesthesia on 9 June 2020. Led by Donogh Burns, Ki Jinn Chin, with expert contributions from Peter Slinger (Toronto General Hospital), Sharon Peacock and Josh Gleicher (Mount Sinai Hospital).
02:50 - Surgical anesthesia with RA vs GA - considerations
05:20 - Planning considerations for a regional anesthetic
09:19 - Alternatives to thoracic epidural
12:30 - Thoracic epidural experience at Mount Sinai Hospital
15:30 - Methods of testing if the epidural works
16:15 - Initial dosing of the thoracic epidural
18:30 - Lumbar CSE and pitfalls in abdominal surgery
19:15 - Choice of level of insertion of thoracic epidural
20:30 - Importance of ultrasound and of waveform analysis
21:17 - Epidural waveform analysis
26:00 - Role of truncal blocks
29:00 - Epidural stimulation (Tsui) test)
33:09 - Thoracic surgery under thoracic epidural anesthesia
36:09 - Thoracic spinal anesthesia and spinal catheters
43:00 - Prevention and management of secondary failure
49:41 - Dosing regimens and intermittent boluses
54:05 - Challenges and strategies in training for thoracic epidurals
59:00 - Ultrasound for thoracic epidurals