The effect of micropore filters on the aspiration test in epidural analgesia.

Continuous epidural analgesia may be complicated by intravascular or subarachnoid injection of local analgesic, with disastrous consequences. One of the techniques described to prevent these complications is the aspiration test. It is the current standard of practice to employ a micropore bacterial filter for epidural infusions. We present an in vitro study of nine commercially available bacterial filters to determine whether or not the aspiration test could be reliably performed through them. Eight of the nine filters (except the Perifix, Braun) were found to be unreliable if air and liquid were both present in the system (air lock). The role of the aspiration test and the use of micropore filters in epidural analgesia are discussed, as are the implications and possible solutions in practice of this cause of failure of the test.