The placement of the epidural catheter at the predicted site by electricalstimulation test

More accurate segmental and sagittal positioning of the epidural catheter t ip is required for the success of continuous epidural analgesia, spinal cor d monitoring, and percutaneous epidural spinal cord stimulation. We examine d the usefulness of an electrical stimulation test for verifying the proper placement of the epidural catheter tip at the predicted site in the poster ior epidural space by using a locally developed epidural catheter with elec trodes at its tip. The test included the observation of segmental bilateral muscle twitches and the patient's report of feeling in the region stimulat ed by moving the epidural catheter electrode back and forth and changing th e direction of the bevel of the Tuohy needle. The success rate of midline p lacement at the required spinal segment was significantly more frequent (99 %; P < 0.001) in the group (n = 289) receiving the electrical stimulation t est compared with the group (n = 277) not receiving the test (success rate 57%). The results indicate the usefulness of this method. We concluded that the electrical stimulation test is effective for verifying the proper plac ement of the catheter electrode tip.