Comparison of Spring-Loaded, Loss of Resistance and Hanging Drop Techniques in Lumbar Epidural Blocks

Güven Gülen1, Taylan Akkaya2, Derya Özkan2, Mehmet Kaydul3, Orhan Gözaydın4, Haluk Gümüş2

1Department Of Anesthesiology And Reanimation, Harput State Hospital, Elazig, Turkey
2I.anesthesiology And Reanimation Clinic&pain Unit, Diskapı Training And Research Hospital,ankara,turkey
3Department Of Anesthesiology And Reanimation,ıgdir State Hospital, Igdir, Turkey
4Department Of Anesthesiology And Reanimation, Semdinli State Hospital, Hakkari, Turkey

Keywords: Spring loaded, loss of resistance, hanging drop, epidural block

Abstract

Objectives: The spring-loaded syringe is a loss of resistance syringe that provide a more objective sign that the epidural space has been entered compared with the traditional techniques. The aim of this study was to compare the time required to locate the epidural space and the backache incidence with the spring-loaded (SL), loss of resistance (LOR) and the hanging drop (HD) techniques for epidural blocks in patients undergoing transurethral resection procedure.
Methods: Sixty patients undergoing transurethral resections were enrolled in the study. The patients were randomly assigned to one of three groups. Epidural block was performed in the first group with a spring-loaded syringe (n=20), in the second group with loss-of-resistance syringe (n=20), and in the third group with the hanging drop technique (n=20). The required time to locate the epidural space, the number of attempts, the incidence of dural puncture and the backache incidence were assessed during the procedure and for four weeks after the procedure in all patients.
Results: The required time to locate the epidural space was 29.1±9.16 seconds in Group 1; 45.25±19.58 seconds in Group 2, and 47.35±11.42 seconds in Group 3 (p<0.001). In Group 1this was significantly shorter than the other two groups. There was no significant difference in the number of attempts, the incidence of dural puncture and backache incidence between the three groups (p>0.05).
Conclusion: The use of SL syringe was found to have a shorter time period to locate the epidural space when compared with the LOR syringe and hanging drop technique.