Background: Identification of the epidural space has a critical role in epidural anesthesia. Epidrum® has been a recently developed air operated device used for identifying the epidural space. This study compares the usage of Epidrum® with saline or air to identify epidural space in performing epidural or combined spinal-epidural(CSE) anesthesia; by paying attention to the ease and duration of the application process, certainty of epidural space distinction, and possible complications.
Methods: Sixty ASA I or II patients between the ages of 18 and 60 years old scheduled for elective gynecologic, orthopedic or hip surgery under CSE anesthesia were enrolled in this study. The patients were randomly assigned to two groups: either, Epidrum® was used with air (Group A) (n=30) or with saline (Group S) (n=30).
Results: No significant differences were noted between the two groups in terms of the time taken to determine the epidural space or the number of attempts required to find it. Deflation time in Group A was statistically shorter than Group S (p=0.024). It was reported that Epidrum® usage with air was easier to apply (73% vs. 30%), and discrimination of the epidural space was more significant (63% vs. 13%) compared to saline (p=0.001 in both groups). No complications were recorded in both groups.
Conclusion: Despite more significant discrimination of the epidural space, shorter deflation time and ease of application of Epidrum® use with air versus saline, saline could be also used successfully in consideration of possible complications with air.