Singhal Suresh, Bala Manju, Kaur Kiranpreet
Department of Anesthesiology and Critical Care, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana, India.
Saudi J Anaesth. 2014 Nov;8(Suppl 1):S41-5. doi: 10.4103/1658-354X.144070.
There are various techniques to identify epidural space but superiority of one technique over other has not been adequately studied. We conducted a study to Compare and evaluate the three techniques for epidural space localization that is, loss of resistance (LOR) syringe technique, balloon technique and drip infusion technique.
Seventy-five patients of either sex, belonging to American Society of Anesthesiologists physical status Class 1 or 2, between 20 and 50 years of age, scheduled to undergo lower abdominal and lower limb surgeries were randomly allocated to one of the three groups (n = 25 each) depending upon epidural space localization. In Group I, epidural space localization was done with LOR syringe technique. In Group II Balloon technique and in Group III drip infusion technique was used. Distance of the epidural space from skin, number of attempts, time taken for epidural space localization and quality of the block were the parameter recorded during the study.
First attempt success rate for epidural space localization was highest in Group III (100%). The mean time taken for epidural space localization was least in Group III, and when compared with other groups it was found to be statistically significant with P = 0.016. Number of attempt for space localization and success rate of the block was better in the majority of patients of Group III, but the difference was found to be statistically nonsignificant. Complication rate was almost negligible in all three techniques.
We conclude that the time taken to localize the epidural space was least in drip infusion technique. As for number of attempts, quality of the block and complications is concerned, all the three techniques are comparable.
有多种识别硬膜外间隙的技术，但一种技术相对于另一种技术的优越性尚未得到充分研究。我们进行了一项研究，以比较和评估三种硬膜外间隙定位技术，即阻力消失（LOR）注射器技术、球囊技术和滴注技术。
75例年龄在20至50岁之间、美国麻醉医师协会身体状况分级为1或2级、计划接受下腹部和下肢手术的患者，根据硬膜外间隙定位随机分为三组（每组n = 25）。第一组采用LOR注射器技术进行硬膜外间隙定位。第二组采用球囊技术，第三组采用滴注技术。研究过程中记录硬膜外间隙距皮肤的距离、尝试次数、硬膜外间隙定位所需时间以及阻滞质量等参数。
第三组硬膜外间隙定位的首次尝试成功率最高（100%）。第三组硬膜外间隙定位的平均时间最短，与其他组相比，差异有统计学意义（P = 0.016）。第三组大多数患者的间隙定位尝试次数和阻滞成功率较好，但差异无统计学意义。所有三种技术的并发症发生率几乎可以忽略不计。
我们得出结论，滴注技术定位硬膜外间隙所需时间最短。至于尝试次数、阻滞质量和并发症方面，所有三种技术相当。
