Epidural needle

Epidural anesthesia is a clinical anesthesia technology, mainly suitable for lower abdominal and lower limb surgery, high epidural anesthesia is mainly used for postoperative analgesia or to reduce the dosage of total anesthesia for general anesthesia combined with epidural anesthesia. Compared with general anesthesia, epidural anesthesia has a lower incidence of pulmonary embolism, deep vein thrombosis, pneumonia, myocardial infarction, wound infection and respiratory depression, and has little impact on the whole body organs, and shortens the patient's hospital stay, thus reducing medical costs

Identification of the epidural space in traditional epidural puncture anesthesia relies on the sudden disappearance of resistance to fluid or air injection when the tip of the Tuohy needle enters the epidural space through the ligamentum flavum. However, the occurrence rate of negative pressure in the epidural space is the highest in the epidural space in the neck and chest, which is about 98%, followed by the waist, which is 88.3%]. There is no negative pressure in the sacral canal, and the negative pressure in the epidural space is affected by some factors, such as cough, breath-holding, pregnancy, etc., which will make the negative pressure in the epidural space smaller, disappear, or even appear positive pressure. So by feelings of epidural anesthesia doctor finger disappear to identify the resistance to epidural space is a kind of operator's subjective judgment, and the effect of epidural puncture success rate and block depended on the experience of anesthesiologists, reportedly experienced anesthesiologist for epidural anesthesia and analgesia in the failure rate of 13% ~ 32%.

Because traditional epidural puncture technology has many uncertain factors and a relatively high failure rate, there are great differences between anesthesiologists in techniques, and there is no standard teaching method, in order to improve the success rate of epidural anesthesia and reduce the risk of epidural anesthesia, objective methods are constantly sought to identify the epidural boundary. This article reviews the current techniques and progress of epidural puncture.

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