TY - THES ID - 137805898 TI - How to Make your Thoracic Epidural Work? AU - Raudsepp, Mark AU - Van De Velde, Marc AU - Coppens, Steve AU - KU Leuven. Faculteit Geneeskunde. Opleiding Master in de specialistische geneeskunde (uitdovend programma vanaf 2019-2020) (Leuven) PY - 2022 PB - Leuven KU Leuven. Faculteit Geneeskunde DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:137805898 AB - Although High Thoracic Epidural analgesia (HTEA) has been replaced as a gold standard in minimal invasive surgical procedures, it still is a viable technique in open major surgery. Performing a HTEA is difficult to master. Published failure rates average from moderate to high. Reduced caseloads further diminish training and competence proficiency, augmenting the problem. We will examine common pitfalls and barriers, while determining factors for success. Finally evaluate novelties to improve favorable results and investigate all modalities to aid successful placement. HTEA is a very effective anesthetic technique which should be reserved for major surgery and preserved for future generations. The training of this approach is progressively more difficult with ever decreasing numbers. Online resources, ultrasound and simulators should be implemented to reach proficiency. Clinical pearls, optimal caseload and training by experts is the best way to go. More research is needed in tools like special syringes and waveform analysis devices to analyze their usefulness. The Tsui test is the ultimate practical test to evaluate successful catheter placement. ER -