The direction of the bevel of the epidural needle

This factor is easy to be ignored, but it does have a certain effect on low back pain after anesthesia. The bevel of the puncture needle is parallel to the longitudinal axis of the body within 2-3 cm of the initial puncture. It is estimated that when reaching the ligamentum flavum, the puncture needle should be rotated 90° until the bevel is perpendicular to the longitudinal axis of the body. During the subsequent puncture, the breakthrough through the ligamentum flavum was experienced. It should be noted that the puncture needle should not be rotated after reaching the epidural space, because the puncture needle may have resisted the dura at this time, and the rotation of the needle body may pierce the dura.

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