Identification of epidural space - which technique should i adopt?

Abstract

Regional anaesthesia, because of its safety and accuracy has an important role in modern anaesthetic practice. Neuraxial anaesthesia has a great impact on all surgical fields and expands the anaesthesiologist's armamentarium. Epidural anaesthesia becomes popular because of advantages like slower onset of action, controlled hypotension and bradycardia, segmental blockade, usefulness in neck and thoracic surgeries and also for the management of postoperative analgesia. The ability of epidural anaesthesia to produce neuraxial anaesthesia and analgesia without dural puncture provides an attractive alternative to spinal anaesthesia. Improvements in equipment, drugs and techniques, has made it popular and a versatile anaesthetic technique. Acceptance of epidural blockade is limited by the fear of failure, neurological complications or slow onset. The success lies on correct identification of epidural space. Hence, choosing a correct method is important. This article mentions various techniques available to identify epidural space that can be adapted.