Pseudo loss of resistance in epidural space localization: A complication of subcutaneous emphysema or simply a faulty technique
2011
Discussion on Pseudo Loss of Resistance in Epidural Space Localization
Commentary
Author Information
Author(s): Amit Jain
Primary Institution: Post Graduate Institute of Medical Education and Research, Chandigarh, India
Conclusion
The authors dispute the conclusions regarding the pseudo loss of resistance in epidural space localization, suggesting that it may be due to improper needle placement rather than air pockets.
Supporting Evidence
- The authors believe that the perceived pseudo loss of resistance could be due to the needle entering the paraspinous muscles.
- An increased chance of false release may occur if the needle enters the interspinous ligament at an oblique angle.
- Multiple causes of air collections in the spinal canal have been described, but pneumatic cysts in spinal ligaments have not been reported.
Takeaway
Sometimes when doctors try to find the right spot for an epidural, they might think they found it when they really didn't, which can happen if the needle goes into the wrong place.
Limitations
The commentary does not provide specific limitations but suggests that many factors were omitted in the original letter.
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