Epidurography

Abstract

Since its introduction into clinical practice in 1921, millions of epidurals are performed daily around the world. Anesthesiologists were quick to grasp its use for prolonged or continuous analgesia and routinely use it alone or in combination with general anesthesia. It has been found to be associated with less complications as compared to spinal analgesia and has taken a major chunk out of spinal practice. The success of epidural depends upon successful location and deposition of drugs into the epidural space. Blind identification of epidural space by loss of resistance or negative epidural space pressure has resulted in mixed results. The figures vary among the researchers but in about 25-30% cases, drugs are deposited at wrong place (outside epidural space). Epidurography offers the best method of confirming the needle or catheter tip location in the space, and has evolved itself a standard practice now. Although very rarely adverse reactions to the technique or the contrast media have been reported, the method is highly recommendable and the pain practitioners and anesthesiologists are encouraged to use it more judiciously