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Korean Journal of Anesthesiology 2009;57(2):181-184.
DOI: https://doi.org/10.4097/kjae.2009.57.2.181   
Drip infusion method as a useful indicator for identification of the epidural space.
Si Young Ok, Seung Hwa Ryoo, Young Hee Baek, Sang Ho Kim, Soon Im Kim, Sun Chong Kim, Wook Park, Dan Song
1Department of Anesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea. syok2377@naver.com
2Department of Surgery, College of Medicine, Soonchunhyang University, Seoul, Korea.
Cervical epidural anesthesia (CEA) is used for pain control and surgical procedures of the head and neck or upper arm areas. However, the failure rate of CEA is reported to be high, is the failure rate being quite higher than other sites, because of the anatomical differences of the cervical spine. We hypothesized that the loss of resistance (LOR) method combined with the drip infusion method for confirmation of the cervical epidural space can reduce the failure rate. This study investigated the usefulness of the drip infusion method. METHODS: One hundred chronic renal failure patients undergoing arteriovenous bridge graft for hemodialysis at the upper arm under cervical epidural anesthesia were recruited for this study. In the cervical epidural puncture, we identified the cervical epidural space using a combination of the LOR method with the drip infusion method. After confirmation of the epidural space with LOR method, we decided it was the true epidural space when fluid dripping to the space was present. Otherwise, if fluid dripping was not present, we designated it was pseudo LOR, and we found the true epidural space using the drip infusion method only. RESULTS: In all cases, the combined LOR with drip infusion method, identify the epidural space. CONCLUSIONS: Combined LOR with drip infusion method is an efficacious method for the confirmation of the cervical epidural space.
Key Words: Cervical epidural puncture; Drip infusion method; Epidural space; Ligamentum flavum; Loss of resistance method


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