scholarly journals The Development of a Novel Device Based on Loss of Guidewire Resistance to Identify Epidural Space in a Porcine Model

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jaeyoung Yang ◽  
Rakmin Choi ◽  
Kyubum Cho ◽  
Seonjin Kim ◽  
Bousung Lee ◽  
...  
Keyword(s):  
3D Printing ◽  
Epidural Space ◽  
Dural Puncture ◽  
Porcine Model ◽  
Guide Wire ◽  
Prototype Model ◽  
Novel Device ◽  
Loss Of Resistance ◽  
Biocompatibility Test ◽  
Wire Resistance

Background. The application of additive manufacturing (3D printing) has been recently expanded to various medical fields. The new technique named loss of guide wire resistance (LOGR) was developed via 3D printing for the detection of epidural space using a guide wire instead of air or saline used in the loss of resistance (LOR) technique. Methods. The prototype model of epidural space finder consists of a polyactic acid (PLA) or a resin. It was manufactured with 3D printing. Biocompatibility test (eluate and sterility tests) was performed in both products. The advantage of the newly developed device was compared with conventional loss of resistance (LOR) technique in a porcine model. Results. Eluate and sterility tests revealed that the PLA was more biocompatible than the resin. The LOGR technique facilitated rapid access to epidural space compared with the LOR technique (41.64 ± 32.18 vs. 92.28 ± 61.46 seconds, N = 14, p=0.0102, paired sample t-test), without any differences in success rate (87.5%). Conclusion. We conclude that LOGR technique is comparable to LOR technique to access the epidural space, although the advantage of either technique in terms of complications such as dural puncture or epidural hematoma is unknown. We demonstrated the potential benefit of 3D printer for the development of a new medical device for anesthesia.

scholarly journals Case Report: Pneumocephalus after labor epidural anesthesia

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 166 ◽  
Author(s):  
Beatriz Nistal-Nuño ◽  
Manuel Ángel Gómez-Ríos
Keyword(s):  
Epidural Space ◽  
Epidural Anesthesia ◽  
Dural Puncture ◽  
Epidural Injection ◽  
Symptomatic Treatment ◽  
Loss Of Resistance ◽  
Computed Tomography Scans ◽  
Lumbar Epidural Anesthesia ◽  
Labor Epidural ◽  
The Brain

Lumbar epidural anesthesia is commonly used for labor analgesia. The 'loss-of- resistance' to air technique (LORA) is generally employed for recognition of the epidural space. One of the rare complications of this technique is pneumocephalus (PC). Here we describe the case of a parturient who developed a frontal headache when locating the epidural space using LORA. On the second day after epidural injection, the patient exhibited occipital headaches with gradual worsening. Computed tomography scans of the brain indicated PC. Following symptomatic treatment, our patient was discharged on the 13th day. We concluded that the amount of air used to identify the epidural space in LORA should be minimized, LORA should not be used after dural puncture and the use of saline avoids PC complications.

An observational pilot study of a novel loss of resistance syringe for locating the epidural space

2021 ◽  
pp. 102984
Author(s):  
M.W. Athar ◽  
N.Guo ◽  
C. Ortner ◽  
B. Carvalho ◽  
G. Abir ◽  
...  
Keyword(s):  
Pilot Study ◽  
Epidural Space ◽  
Loss Of Resistance

Loss of Resistance to Saline with a Bubble of Air to Identify the Epidural Space in Infants and Children: A Prospective Study

2000 ◽  
Vol 90 (1) ◽  
pp. 59-61 ◽  
Author(s):  
Fabienne Roelants ◽  
Francis Veyckemans ◽  
Luc Van Obbergh ◽  
François Singelyn ◽  
Hilde Waterloos ◽  
...  
Keyword(s):  
Prospective Study ◽  
Epidural Space ◽  
Infants And Children ◽  
Loss Of Resistance ◽  
A Prospective Study ◽  
In Infants And Children

scholarly journals Continuous or intermittent loss of resistance for identifying the epidural space

Anaesthesia ◽  
2000 ◽  
Vol 55 (5) ◽  
pp. 489-518 ◽  
Author(s):  
M. J. L. Scrutton ◽  
S. M. Kinsella
Keyword(s):  
Epidural Space ◽  
Loss Of Resistance

Air versus saline in the loss of resistance technique for the identification of the epidural space

2011 ◽  
Author(s):  
Pedro L Antibas ◽  
Regina P El Dib ◽  
Adriana Bassi ◽  
José Fausto de Morais
Keyword(s):  
Epidural Space ◽  
Loss Of Resistance

Complication analysis of epidural space identification - a meta-analysis of air vs. saline technique for loss of resistance

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 86
Author(s):  
R. Schier ◽  
D. Guerra ◽  
G. Pratt ◽  
K. Boddu ◽  
B. Riedel
Keyword(s):  
Epidural Space ◽  
Meta Analysis ◽  
Loss Of Resistance

Post–Dural Puncture Headache

2017 ◽  
Author(s):  
Philip Rubin
Keyword(s):  
Cerebrospinal Fluid ◽  
Epidural Space ◽  
Gold Standard ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Autologous Blood ◽  
Caffeine Intake ◽  
Recumbent Position ◽  
Post Dural Puncture Headache ◽  
Blood Patch

Post–dural puncture headache (PDPH) is a benign but debilitating condition that may occur as a consequence of any dural puncture, whether intentional (as with spinal anesthesia or lumbar puncture) or inadvertent (as with epidural anesthesia). The headache is characteristically unique, as it is postural in nature—worsened when sitting or standing, and markedly improved in the recumbent position. After the puncture, passage of cerebrospinal fluid (CSF) across the dura mater from a pressurized environment (subarachnoid space) to the epidural space, is the initial culprit behind the headache. Noninvasive conservative measures including hydration, analgesics, and caffeine intake are typically offered as initial treatments, but if those measures fail, the “gold standard” epidural blood patch is commonly offered. This procedure entails injection of autologous blood into the epidural space to both halt continued CSF “loss,” and to increase CSF pressure, both of which aid in headache resolution.

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