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TECHNIQUES AND APPROACHES TO EPIDURAL SPACE IDENTIFICATION - REVIEW

Thuraya Abdullah Hummadi, Ebtihaj Abdo Fqiry, Yussra Omar Solan

Anesthesiologists need to be knowledgeable about the benefits and negative aspects of these arising technologies, to examine which methods to adopt. Additionally, expertise concerning of these more recent technologies is essential to lead future research study in this avenue. The aim of this review is to summarize the arising technologies for identifying the EDS and their possible role in the future. We performed a search using electronic databases; MEDLINE, and EMBASE, throughout 2018. Search strategies used following MeSH terms in searching: “epidural space identification”, “Epidural anesthesia”, “technique”, “assessment”. An optimal approach to recognize EDS should be simple to discover and execute, quickly reproducible with high level of sensitivity and uniqueness, and determine unintended intrathecal and intravascular catheter placements effortlessly. It is also essential to consider the accessibility of sources, clinical feasibility, and cost-benefit benefit prior to taking on any kind of new technology. Though none of the newer techniques have currently replaced conventional LOR, some have found use in unique circumstances and hence could be complimentary to LOR. Ultrasound is progressively being used as a rescue technique when a patient with difficult anatomy is experienced.

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