BACKGROUND Current methods of locating the epidural space rely on surface anatomical landmarks and loss-of-resistance (LOR). We are not aware of any data describing real-time ultrasound (US)-guided epidural access in adults. METHODS We evaluated the feasibility of performing real-time US-guided paramedian epidural access with the epidural needle inserted in the plane of the US beam in 15 adul...

An inflammatory pseudotumor (IPT) is a rare benign lesion, characterized by nonneoplastic proliferation of inflammatory cells and presence of intermingling collagen fibers. IPT commonly occurs in the lungs and orbita, while an intraspinal IPT is extremely rare. IPT can mimic both clinically and radiologically malignant processes, and making a definitive preoperative diagnosis is often difficult...

BACKGROUND No reports exist concerning in vivo optical coherence tomography visualization of the epidural space and the blood patch process in the epidural space. In this study, we produced real-time two-dimensional and reconstructed three-dimensional images of the epidural space by using optical coherence tomography in a porcine model. We also aimed to produce three-dimensional optical coheren...

BACKGROUND We herein provide an analysis of lumbar epidural catheterization, which outlines a detailed anatomical description of the epidural anatomy, and may improve the success rate of neuraxial cannulation. METHODS Lumbar epidural catheters were placed in 50 adult embalmed cadavers. After catheterization, the lumbar dura and connecting structures between the epidural space and the vertebra...

BACKGROUND Previously, Balki determined the Pearson correlation coefficient with the use of ultrasound (US) was 0.85 in morbidly obese parturients. We aimed to determine if the use of the epidural depth equation (EDE) in conjunction with US can provide better clinical correlation in estimating the distance from the skin to the epidural space in morbidly obese parturients. METHODS One hundred ...

Background: We report the analgesic efficacy of lumbar epidural adenosine injection in reducing the chronic neuropathic pain in a patient with primitive neuroectodermal tumor. Report of the Case: In this case report a 13-year-old male with primary neuroectodermal tumor (PNET) was administered in epidural space with adenosine to reduce his pain. The patient received 10ml of 0.25% ropivacaine ...

BACKGROUND AND OBJECTIVES Approaching the cervical and high thoracic level epidural space through transepidural route from lumbar region represents a method to lower the occurrence of complications associated with direct approach. The authors performed a cadaveric pilot project to determine the feasibility of various catheter-based manipulation and cephalad advancement using the transepidural r...

BACKGROUND Epidrum® is a recently developed, air operated, loss of resistance (LOR) device for identifying the epidural space. We investigated the usefulness of Epidrum® by comparing it with the conventional LOR technique for identifying the epidural space. METHODS One hundred eight American Society of Anesthesiologists (ASA) physical status I or II patients between the ages of 17 and 68 year...

Epidural catheters inserted 8 cm within the epidural space are more likely to result in intravenous cannulation and unilateral block1. Epidural catheters inserted 2 or 4 cm within the epidural space are more likely to be dislodged than epidural catheters inserted 6 or 8 cm.1 Obese patients are at particular risk of epidural catheter displacement2. It is recommended that epidural catheters shoul...

BACKGROUND AND OBJECTIVES Epidural approach angle is one of the determining factors for needle traveling length to reach the epidural space. Likewise, the margin of safety against accidental dural puncture should be affected by epidural approach angle because the space available for epidural needle tip movement in the epidural space is depending on the inserting angle to the epidural space. The...