Primarily the spread of local anaesthetic is dependent on factors that may affect spread in epidural space: 1. The volume of local anaesthetic 2. Age: Older patients need lesser local anaesthetic 3. Pregnancy and an intraabdominal tumour or mass compressing lumbar curvature. Requires approximately= 30? less local anaesthetic. 4. Obesity: May or may not require less dosage; unpredictable dosing, the better way is to titrate the dosage.
5. Height: Taller patients require more drug as dermatomes are larger and vertebral column is more lengthy. 6. Altered spinal anatomy: Scoliosis and/or kyphosis, the local anaesthetic spread is hampered so the level cannot be fixed, and patchy block may occur, may require more or less dosage. 7. Type of Surgery: Lower or upper abdominal surgeries or only for analgesia like in thoracotomy 8. Backache unexplainable: Inj kenacort + local anaesthetic +…
