Hologram-assisted thoracic epidural insertion in the Thiel soft embalmed cadaver: proof of concept simulation study

Thoracic epidural analgesia (TEA) provides pain relief after abdominal surgery sufficient to allow coughing and early return of bowel function. However, high primary1 and secondary2 complication rates have driven anaesthetists towards safer, albeit less efficacious, ultrasound-guided abdominal wall fascial plane blocks. Unfortunately, the latter fail to block afferent visceral neural pathways and sympathetic efferent nerves,3 and consequently have negligible effect on gastrointestinal motility or splanchnic blood flow. Hence, TEA remains the gold standard analgesic technique after bilateral fractured ribs and open upper gastrointestinal, oesophageal, and vascular surgery.