title: Identification of epidural space using loss of resistance syringe, infusion drip, and balloon technique: A comparative study.
abstract: OBJECTIVE
  There are various techniques to identify epidural space but superiority of one technique over other has not been adequately studied. We conducted a study to Compare and evaluate the three techniques for epidural space localization that is, loss of resistance (LOR) syringe technique, balloon technique and drip infusion technique.
  
  
  METHODS
  Seventy-five patients of either sex, belonging to American Society of Anesthesiologists physical status Class 1 or 2, between 20 and 50 years of age, scheduled to undergo lower abdominal and lower limb surgeries were randomly allocated to one of the three groups (n = 25 each) depending upon epidural space localization. In Group I, epidural space localization was done with LOR syringe technique. In Group II Balloon technique and in Group III drip infusion technique was used. Distance of the epidural space from skin, number of attempts, time taken for epidural space localization and quality of the block were the parameter recorded during the study.
  
  
  RESULTS
  First attempt success rate for epidural space localization was highest in Group III (100%). The mean time taken for epidural space localization was least in Group III, and when compared with other groups it was found to be statistically significant with P = 0.016. Number of attempt for space localization and success rate of the block was better in the majority of patients of Group III, but the difference was found to be statistically nonsignificant. Complication rate was almost negligible in all three techniques.
  
  
  CONCLUSIONS
  We conclude that the time taken to localize the epidural space was least in drip infusion technique. As for number of attempts, quality of the block and complications is concerned, all the three techniques are comparable.
authors.affiliation: Department of Anesthesiology and Critical Care, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Singhal
authors.affiliation: Department of Anesthesiology and Critical Care, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana, India.
authors.forename: Manju
authors.initials: M
authors.lastname: Bala
authors.affiliation: Department of Anesthesiology and Critical Care, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana, India.
authors.forename: Kiranpreet
authors.initials: K
authors.lastname: Kaur
keywords: Balloon technique; drip infusion technique; epidural space localization; loss of resistance syringe technique