title: The Episure Autodetect syringe, a loss-of-resistance technique for locating the epidural space, used in pediatric patients.
abstract: BACKGROUND
  The Episure Autodetect syringe, a spring-loaded syringe, is a loss-of-resistance syringe with an internal compression that applies constant pressure on the plunger. As the principle of loss-of-resistance is the same for adult and for pediatric patients, the Episure Autodetect syringe should be able to identify correctly the epidural space also in pediatric patients.
  
  
  METHODS
  A retrospective review was carried out for all pediatric patients, in which the Episure Autodetect syringe was used for locating the epidural space between 2007 and 2011 in our department.
  
  
  RESULTS
  In 17 pediatric patients (9 months-14 years, 7.5-43 kg weight), the Episure syringe was used. In all 17 patients, the epidural space was correctly identified using the spring-loaded syringe as evidenced by satisfactory analgesia. No accidental dural punctures or false loss-of-resistances were observed.
  
  
  CONCLUSIONS
  The spring-loaded Episure Autodetect syringe might be a potentially useful loss-of-resistance syringe for identification of the epidural space in pediatric patients.
authors.affiliation: Department of Anesthesiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. l.tielens@anes.umcn.nl
authors.forename: Luc K P
authors.initials: LK
authors.lastname: Tielens
authors.forename: Jörgen
authors.initials: J
authors.lastname: Bruhn
authors.forename: Mark
authors.initials: M
authors.lastname: Vogt
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: van Geffen
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: Scheffer
mesh_terms: D000293:Adolescent; D000767:Anesthesia, Epidural / Q000295:instrumentation* / Q000379:methods*; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D000779:Anesthetics, Local; D002045:Bupivacaine; D002648:Child; D002675:Child, Preschool; D004824:Epidural Space / Q000033:anatomy & histology*; D004837:Epinephrine; D005260:Female; D006801:Humans; D007223:Infant; D007267:Injections; D007813:Laparotomy; D008297:Male; D011229:Preanesthetic Medication; D012189:Retrospective Studies; D013594:Syringes; D019616:Thoracic Surgical Procedures; D014662:Vasoconstrictor Agents
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002045:Bupivacaine; D004837:Epinephrine
keywords: epidural anesthesia; pediatric; postoperative analgesia; postoperative pain