Comparison of Intraoperative and Postoperative Effects of Lateral Epidural and Midline Epidural Anaesthesia in Patients Undergoing Unilateral Lower Extremity Operation

Objective: We aimed to compare lateral and midline epidural anaesthesia using a levobupivacaine-fentanyl combination in patients undergoing unilateral lower extremity operation for anaesthetic effects and postoperative complications. Methods: The study included 40 American Society of Anesthesiologists (ASA) I-II group patients. At the L4-5 space, an epidural catheter was placed in patients in Group 1 by directing the tip of the needle at a 45-degree angle to the operation side and in Group 2 with the needle tip in the cephalad direction. Patients in both groups were administered a combination of 10 mL 0.5% levobupivacaine and 50 mu g fentanyl via the epidural catheter. Sensorial and motor block levels during the perioperative and postoperative periods and postoperative complications were recorded. Results: The maximum level of sensory block on the operated side was found to be at the T10 (T8-T10) level in both groups, while the level of sensory block on the non-operated side was at the L2 (L3-T10) level in Group 1, and at the T10 (T8-T10) level in Group 2 (p=0.000). The motor block was more intense on the non-operated side in Group 2 than in Group 1. The postoperative motor block ended earlier in Group 1. The incidence of complication development was similar between the groups. Conclusion: With a shorter lasting and lower level sensorial and motor block, lateral epidural anaesthesia may be a more advantageous method than midline epidural anaesthesia.