open access

Vol 48, No 4 (2016)
Original and clinical articles
Submitted: 2016-10-28
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Comparison of the techniques for the identification of the epidural space using the loss-of-resistance technique or an automated syringe — results of a randomized double-blind study

Larysa Duniec, Piotr Nowakowski, Jakub Sieczko, Marcin Chlebus, Tomasz Łazowski
DOI: 10.5603/AIT.2016.0047
·
Anaesthesiol Intensive Ther 2016;48(4):228-233.

open access

Vol 48, No 4 (2016)
Original and clinical articles
Submitted: 2016-10-28

Abstract

BACKGROUND: The conventional, loss of resistance technique for identification of the epidural space is highly dependent on the anaesthetist’s personal experience and is susceptible to technical errors. Therefore, an alternative, automated technique was devised to overcome the drawbacks of the traditional method. The aim of the study was to compare the efficacy of epidural space identification and the complication rate between the two groups — the automatic syringe and conventional loss of resistance methods.

METHODS: 47 patients scheduled for orthopaedic and gynaecology procedures under epidural anaesthesia were enrolled into the study. The number of attempts, ease of epidural space identification, complication rate and the patients’ acceptance regarding the two techniques were evaluated.

RESULTS: The majority of blocks were performed by trainee anaesthetists (91.5%). No statistical difference was found between the number of needle insertion attempts (1 vs. 2), the efficacy of epidural anaesthesia or the number of complications between the groups. The ease of epidural space identification, as assessed by an anaesthetist, was significantly better (P = 0.011) in the automated group (87.5% vs. 52.4%). A similar number of patients (92% vs. 94%) in both groups stated they would accept epidural anaesthesia in the future.

CONCLUSION: The automated and loss of resistance methods of epidural space identification were proved to be equivalent in terms of efficacy and safety. Since the use of the automated technique may facilitate epidural space identification, it may be regarded as useful technique for anaesthetists inexperienced in epidural anaesthesia, or for trainees.

Abstract

BACKGROUND: The conventional, loss of resistance technique for identification of the epidural space is highly dependent on the anaesthetist’s personal experience and is susceptible to technical errors. Therefore, an alternative, automated technique was devised to overcome the drawbacks of the traditional method. The aim of the study was to compare the efficacy of epidural space identification and the complication rate between the two groups — the automatic syringe and conventional loss of resistance methods.

METHODS: 47 patients scheduled for orthopaedic and gynaecology procedures under epidural anaesthesia were enrolled into the study. The number of attempts, ease of epidural space identification, complication rate and the patients’ acceptance regarding the two techniques were evaluated.

RESULTS: The majority of blocks were performed by trainee anaesthetists (91.5%). No statistical difference was found between the number of needle insertion attempts (1 vs. 2), the efficacy of epidural anaesthesia or the number of complications between the groups. The ease of epidural space identification, as assessed by an anaesthetist, was significantly better (P = 0.011) in the automated group (87.5% vs. 52.4%). A similar number of patients (92% vs. 94%) in both groups stated they would accept epidural anaesthesia in the future.

CONCLUSION: The automated and loss of resistance methods of epidural space identification were proved to be equivalent in terms of efficacy and safety. Since the use of the automated technique may facilitate epidural space identification, it may be regarded as useful technique for anaesthetists inexperienced in epidural anaesthesia, or for trainees.

Get Citation

Keywords

epidural anaesthesia; epidural space, automatic identification; epidural space, identification, loss-ofresistance technique

About this article
Title

Comparison of the techniques for the identification of the epidural space using the loss-of-resistance technique or an automated syringe — results of a randomized double-blind study

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 4 (2016)

Pages

228-233

DOI

10.5603/AIT.2016.0047

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(4):228-233.

Keywords

epidural anaesthesia
epidural space
automatic identification
epidural space
identification
loss-ofresistance technique

Authors

Larysa Duniec
Piotr Nowakowski
Jakub Sieczko
Marcin Chlebus
Tomasz Łazowski

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