epiduralkanyl

An epidural needle is a specialized medical instrument designed to access the epidural space, the area surrounding the spinal cord within the vertebral canal. It is used to administer local anesthetics and opioids for regional anesthesia or analgesia. Clinically, epidural anesthesia is widely used for labor and delivery, intraoperative anesthesia, postoperative pain control, and certain chronic pain therapies.

Designs and types: The most widely used epidural needle is the Tuohy needle, which has a curved, blunt tip and a side opening to facilitate catheter introduction into the epidural space. Pencil-point needles, such as Whitacre and Sprotte variants, are related in design to spinal needles and may be used in specific settings to reduce the risk of accidental dural puncture. Catheters are threaded through the needle into the epidural space for continuous or intermittent drug delivery.

Technique overview: The needle is positioned to reach the lumbar region and the epidural space is identified by a loss-of-resistance test with saline or, less commonly, air. Through the needle, a flexible catheter is advanced into the epidural space; after removing the needle, analgesic or anesthetic solutions can be infused through the catheter with or without a continuous infusion.

Indications and use: Labor analgesia, regional anesthesia for abdominal, thoracic, or orthopedic surgery, and postoperative pain control. In some cases, combined spinal-epidural anesthesia may be employed for rapid onset with extended duration.

Complications and considerations: Potential complications include inadvertent dural puncture with post-dural puncture headache, infection, hematoma, catheter malposition or migration, nerve injury, or local anesthetic systemic toxicity if injected intravascularly. Contraindications include patient refusal, active infection at the insertion site, coagulopathy, or increased intracranial pressure. The procedure requires trained anesthesia personnel and strict aseptic technique.