WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Dr. Alhussein Mohammed Saleh Alhaddad*, Dr. Ali Abdulhammed Mohammed Ali and
Dr. Hassanain Qahtan Mohammed Albayati

ABSTRACT

Background: Loss of resistance epidural technique is the most popular technique for localizing epidural space in anesthesia, yet the medium used in this technique still a matter of debate. Epidural anesthesia has a wide range of applications in both obstetric and non-obstetric settings. Aim of the study: To compare between the use of air or saline medium to locate epidural space in loss of resistance technique. Patient and Methods: A double-blind clinical trial study carried out at Baghdad Medical City during a period of one year from January 2022 to January 2023. It included 40 patients with ASA class 1,2 and 3 undergoing lower limb orthopedic and plastic surgeries. They were randomly assigned in two groups; air group used 3 ml air and saline group used 3ml saline 0.9% as a medium in loss of resistance technique for identification of epidural space. Results: Difficult epidural space identification and two attempts occurred in 60% of saline group which was significantly higher than that in air group. No significant difference in pain score in all times, onset of sensory, motor block and difficulty in epidural catheter insertion. Adverse outcomes like; accidental intravascular, intrathecal catheter insertion, accidental dural puncture, unilateral block was not encountered in both groups. Conclusion: Using air as a medium for loss of resistance technique to locate epidural space has better success rates with fewer number of attempts. We recommend further studies with a larger number of cases.