Open AccessObjective Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology: A Randomized Controlled Comparison With Fluoroscopy and Traditional Loss of Resistance
Author(s) -
Ralf E. Gebhard,
Tobias Moeller-Bertram,
Douglas Dobecki,
Feyce M. Peralta,
Evan G. Pivalizza,
Madhumani Rupasinghe,
Sanja Ilić,
Mark Hochman
Publication year - 2019
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/ane.0000000000003873
Subject(s) - medicine , fluoroscopy , lumbar , epidural space , randomized controlled trial , confidence interval , catheter , odds ratio , anesthesia , surgery
Performance of epidural anesthesia and analgesia depends on successful identification of the epidural space (ES). While multiple investigations have described objective and alternative methodologies to identify the ES, traditional loss of resistance (LOR) and fluoroscopy (FC) are currently standard of care in labor and delivery (L&D) and chronic pain (CP) management, respectively. While FC is associated with high success, it exposes patients to radiation and requires appropriate radiological equipment. LOR is simple but subjective and consequently associated with higher failure rates. The purpose of this investigation was to compare continuous, quantitative, real-time, needle-tip pressure sensing using a novel computer-controlled ES identification technology to FC and LOR for lumbar ES identification.