2015
DOI: 10.1097/aap.0000000000000217
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Confirmation of Loss-of-Resistance for Epidural Analgesia

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Cited by 36 publications
(38 citation statements)
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“…In other words, if cerebrospinal fluid return is obtained through the spinal needle, the epidural needle tip is most likely positioned in the epidural space. This confirmatory measure can be especially useful for technically challenging epidural blocks 10. If DPEA is performed for this purpose, onset becomes a lesser concern, and the operator should use the smallest spinal needle size available to minimize the incidence of post meningeal puncture headache.…”
Section: Discussionmentioning
confidence: 99%
“…In other words, if cerebrospinal fluid return is obtained through the spinal needle, the epidural needle tip is most likely positioned in the epidural space. This confirmatory measure can be especially useful for technically challenging epidural blocks 10. If DPEA is performed for this purpose, onset becomes a lesser concern, and the operator should use the smallest spinal needle size available to minimize the incidence of post meningeal puncture headache.…”
Section: Discussionmentioning
confidence: 99%
“…27 Using computed tomography scanning, Hogan 28 has previously reported adequate epidural blocks with a variety of catheter tip positions. In fact, the author concluded that "the epidural space is a forgiving system, and markedly different sites of catheter tips and spread of injected solution resulted are compatible with adequate anesthetic effect."…”
Section: Primary Failure Of Tea In Training Centersmentioning
confidence: 99%
“…When the needle tip is correctly positioned inside the epidural space, pressure measurement results in a pulsatile waveform synchronized with arterial pulsations. 1 In a recent case series of 160 thoracic epidural blocks, the sensitivity, specificity, positive, and negative predictive values of EWA were found to be 91.1%, 83.8%, 94.9%, and 73.8%, respectively. 9 In our teaching institutions, the primary failure rate of thoracic epidural blocks is 23.1%.…”
mentioning
confidence: 95%
“…T he thoracic epidural space is most commonly identified with loss of resistance (LOR) to air or normal saline. 1 Although sensitive, LOR lacks specificity, as cysts in interspinous ligaments, 2 gaps in ligamentum flavum, [3][4][5] paravertebral muscles, 6 thoracic paravertebral spaces, 7 and intermuscular planes 8 can yield nonepidural LOR. Epidural waveform analysis (EWA) provides a simple confirmatory adjunct for LOR.…”
mentioning
confidence: 99%