Objective techniques for identification of the epidural space in infants and children.

摘要

I read with interest the results of a survey of Canadian pediatric anesthesiologists regarding identification of the epidural space in infants and children.1 However, I was somewhat disappointed to learn that the iv micro-drip infusion set technique for identification of the space2 is not being practiced in Canada. This technique enables the operator to hold the epidural needle with two hands, thus providing more precise control of the needle, and identify the epidural space by an objective sign, either free flow of fluid from the drip chamber, or by movement of a tiny air bubble at the hub of the needle towards the epidural space. We have used this technique in more than 2,000 infants and children at our institution. In 1,385 infants and children, lumbar epidural puncture was successful on the first attempt (90.2%) and on the second attempt in an additional 8.0%.