title: Acute tissue damage following epidural cannulation: a comparison between the midline and paramedian approach in obstetric patients.
abstract: Forty obstetric patients were randomly allocated to receive either a midline or paramedian approach to the epidural space using loss of resistance to air. Tissue trauma was assessed by blinded observers, clinically by the presence of pain and radiologically using magnetic resonance imaging (MRI). Technical difficulties with imaging reduced those who were scanned to 10 in the paramedian group and 8 in the midline group. Lateralizing signs of tissue oedema were not related to the method of epidural cannulation. There was no significant difference in localized back pain between the two groups, and this was not related to MRI findings. Pain did not persist for more than 4 days.
authors.affiliation: Department of Anaesthetics, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
authors.forename: A
authors.initials: A
authors.lastname: Holdcroft
authors.forename: G
authors.initials: G
authors.lastname: Samsoon
authors.forename: R A
authors.initials: RA
authors.lastname: Fernando
authors.forename: C
authors.initials: C
authors.lastname: Baudouin