A DUAL TECHNIQUE FOR IDENTIFICATION OF THE EPIDURAL SPACE

A method of identifying the epidural space is described in which the t raditional loss of resistance to air technique is combined with amplif ication of the sound made by the epidural needle as it traverses the i nterspinous ligament and the ligamentum flavum and then enters the epi dural space. The method retains all the advantages of the loss of resi stance to air technique whilst, in addition, the auditory amplificatio n gives a slightly earlier warning of entry into the epidural space. T he apparatus necessary is readily available and the technique is easy to use. In addition to being useful in difficult epidurals, the techni que would also be an excellent teaching aid.