Surgical removal of broken epidural catheter

While practicing anesthesia in developing and underdeveloped countries, it is important to consider not only the quality of anesthesia but also the cost-effectiveness. I read the article by Singh et al. where the author mentions cost-effective indigenous drug delivery system for nerve blocks.[1] The mentioned technique is an attempt and concentrated mainly on cost-effectiveness. We do regularly practice peripheral nerve blocks with or without ultrasound guidance. We do take care of cost of each material used. Our technique is more cost-effective, less cumbersome, airtight, easy, takes care of sterility, and is also readily available. We routinely use a male to female pressure monitoring tubing for the delivery of local anesthetic during peripheral nerve block, which is available in various lengths and anesthesiologist can choose depending on comfort. One end of it is connected to needle and the other end to a 20-ml syringe, as shown in the Figure 1. We prime the tubing and needle with local anesthetic before we proceed for the block to remove air. The assistant injects the drug from the syringe after negative aspiration for the blood. The operator can hold the needle with great comfort and can concentrate on locating nerve or plexus. This technique saves time, is sterile, uses less resources, is easy, cost-effective, airtight, and readily available.