Fyneface-Ogan S, Mato C N
Obstetric Anesthesia Unit, Department Of Anesthesia, Edith Wolfson Medical Centre, Holon 58100, Israel.
Nig Q J Hosp Med. 2008 Jul-Sep;18(3):166-9. doi: 10.4314/nqjhm.v18i3.45021.
Localisation of the epidural space is one of the key steps in the provision of epidural analgesia during childbirth. Many ingenious devices have been designed to improve the success of the puncture procedure. A clinical experience with a modified Macintosh epidural balloon in the localisation of the epidural space is described.
Fifty ASA Class I-II consecutive parturients requesting pain relief in labour were enrolled in this prospectively randomized study. They were allocated to receive either air (LORA) or epidural balloon (EB) to assist in the identification of the epidural space. The end-point for the EB was marked by the collapse of the balloon while this was depended on the loss of resistance felt on the syringe plunger in the LORA. The primary outcome was ease of epidural space identification and adequate pain relief between the two groups.
There were no statistical differences in age, height, weight, gestational age, gravidity and parity between the two groups. Twenty-two women in the EB group had a successful localisation at first attempt as compared to 14 women in the LORA group (p < 0.0126). The time taken to localise the epidural space was less in the EB than the LORA, (p < 0.0001). There were more Accidental Dural Punctures and failed blocks in the LORA group. The overall quality of block was better in the EB group.
The epidural space was identified more often at the first attempt, and more swiftly, with the epidural balloon.
