title: Comparison of spring-loaded, loss of resistance and hanging drop techniques in lumbar epidural blocks.
abstract: OBJECTIVE
  The spring-loaded syringe is a loss of resistance syringe that provide a more objective sign that the epidural space has been entered compared with the traditional techniques. The aim of this study was to compare the time required to locate the epidural space and the backache incidence with the spring-loaded (SL), loss of resistance (LOR) and the hanging drop (HD) techniques for epidural blocks in patients undergoing transurethral resection procedure.
  
  
  METHODS
  Sixty patients undergoing transurethral resections were enrolled in the study. The patients were randomly assigned to one of three groups. Epidural block was performed in the first group with a spring-loaded syringe (n=20), in the second group with loss-of-resistance syringe (n=20), and in the third group with the hanging drop technique (n=20). The required time to locate the epidural space, the number of attempts, the incidence of dural puncture and the backache incidence were assessed during the procedure and for four weeks after the procedure in all patients.
  
  
  RESULTS
  The required time to locate the epidural space was 29.1 ± 9.16 seconds in Group 1; 45.25 ± 19.58 seconds in Group 2, and 47.35 ± 11.42 seconds in Group 3 (p<0.001). In Group 1 this was significantly shorter than the other two groups. There was no significant difference in the number of attempts, the incidence of dural puncture and backache incidence between the three groups (p>0.05).
  
  
  CONCLUSIONS
  The use of SL syringe was found to have a shorter time period to locate the epidural space when compared with the LOR syringe and hanging drop technique.
authors.affiliation: Department of Anesthesiology and Reanimation, Harput State Hospital, Elazığ, Turkey.
authors.forename: Güven
authors.initials: G
authors.lastname: Gülen
authors.forename: Taylan
authors.initials: T
authors.lastname: Akkaya
authors.forename: Derya
authors.initials: D
authors.lastname: Ozkan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kaydul
authors.forename: Orhan
authors.initials: O
authors.lastname: Gözaydin
authors.forename: Haluk
authors.initials: H
authors.lastname: Gümüş
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D001416:Back Pain / Q000209:etiology*; D004824:Epidural Space; D006801:Humans; D008161:Lumbosacral Region; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D013594:Syringes / Q000145:classification; D013997:Time Factors