Techniques for identifying the epidural space: a survey of practice amongst anaesthetists in the UK

Summary A postal survey of all UK members of the Obstetric Anaesthetists' Association was carried out to ascertain their preferred method for identifying the epidural space in obstetric and non‐obstetric patients. Over 1200 questionnaires were returned (79.3% response rate). In obstetric patien...

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Published in:Anaesthesia 2006-04, Vol.61 (4), p.370-375
Main Authors: Wantman, A., Hancox, N., Howell, P. R.
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia, Epidural - methods
Anesthesia, General
Anesthesia, Obstetrical - methods
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Awareness
Biological and medical sciences
Clinical Competence
Female
Health Care Surveys
Humans
Medical sciences
Obstetrics
Polls & surveys
Pregnancy
Professional Practice - statistics & numerical data
Sodium Chloride
Surveys and Questionnaires
United Kingdom
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description Summary A postal survey of all UK members of the Obstetric Anaesthetists' Association was carried out to ascertain their preferred method for identifying the epidural space in obstetric and non‐obstetric patients. Over 1200 questionnaires were returned (79.3% response rate). In obstetric patients, the single most common technique (used by 58% of anaesthetists) was continuous advancement of the epidural needle and loss of resistance with saline, followed by intermittent needle advancement with air (21%). A minority of respondents used other variants, including intermittent advancement with saline (16%) and continuous advancement with air (4%). Consultant anaesthetists showed greater variety in techniques used than did trainees (p 
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Only 48% of anaesthetists said they would try an alternative if they experienced difficulty with their preferred technique. A similar pattern was seen for lumbar epidurals in non‐obstetric surgical patients (89% used the same technique as in obstetrics), although for thoracic epidurals, 23% used a different technique to that which they would use for obstetrics, and the paramedian approach was more popular (21%). 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Less than 5% of respondents used a paramedian approach, and these were almost exclusively senior staff. Only 48% of anaesthetists said they would try an alternative if they experienced difficulty with their preferred technique. A similar pattern was seen for lumbar epidurals in non‐obstetric surgical patients (89% used the same technique as in obstetrics), although for thoracic epidurals, 23% used a different technique to that which they would use for obstetrics, and the paramedian approach was more popular (21%). When inserting lumbar epidurals to supplement general anaesthesia in surgical patients, 18% of anaesthetists said they usually performed the block with the patient asleep, whereas for thoracic epidurals, this figure fell to 14%.</description><subject>Anesthesia</subject><subject>Anesthesia, Epidural - methods</subject><subject>Anesthesia, General</subject><subject>Anesthesia, Obstetrical - methods</subject><subject>Anesthesia. Intensive care medicine. Transfusions. 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source Wiley-Blackwell Read & Publish Collection
subjects Anesthesia
Anesthesia, Epidural - methods
Anesthesia, General
Anesthesia, Obstetrical - methods
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Awareness
Biological and medical sciences
Clinical Competence
Female
Health Care Surveys
Humans
Medical sciences
Obstetrics
Polls & surveys
Pregnancy
Professional Practice - statistics & numerical data
Sodium Chloride
Surveys and Questionnaires
United Kingdom
title Techniques for identifying the epidural space: a survey of practice amongst anaesthetists in the UK
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