Confirmation of epidural catheter placement in epidural space using ultrasound color flow doppler - a prospective observational study

TRADITIONALLY, EPIDURAL SPACE IS IDENTIFIED BY LOSS OF RESISTANCE TECHNIQUE, WHIUCH WAS FIRST DESCRIBED BY SICARD AND FORESTIER IN 1921. INCORRECT PLACEMENT OF EPIDURAL CATHETER IS REPORTED TO OCCUR IN 12-40% OF THE CASES. FAILURE TO CORRECTLY PLACE A EPIDURAL CATHTER LEADS TO INADEQUATE ANALGESIA AND SERIOUS COMPLICATIONS LIKE DURAL PUNCTURE HEADACHE.

SINCE, THE SUCCESS OF EPIDURAL ANALGESIA DEPENDS ON THE LOCATION OF THE EPIDURAL CATHETER IN THE EPIDUAL SPACE, A SIMPLE AND NON INVASIVE BEDSIDE METHOD TO CONFIRM ITS LOCATION WOULD BE BENEFICIAL. ULTRASOUND IS NON INVASIVE AND GIVES A SIGNIFICANT AND ACCURATE  INFORMATION REGARDING THE FLOW ACROSS ANY AREA. HENCE WE PROPOSE TO UTILISE THE ULTRASOUND TO CONFIRM THE CORRECT PLACEMENT OF THE EPIDURAL CATHETER USING THE COLOUR FLOW DOPPLER.