Anyone who has been around junior residents in anesthesiology on their first day in the L&D suite knows the risk of the dreaded “wet tap” – inadvertent dural puncture during attempted epidural access can lead to headaches (for the patient and the doctor), the need for a blood patch, and possible neurological damage. The traditionally taught method is “loss of resistance,” but it is quite subjective. The EpiDrum, from Exmoor Innovations (Taunton, UK), aims to change that.
From the company website:
The Epidrum is an optimal, constant, low pressure LOR device to facilitate epidural procedures. Interposed between needle and syringe, the device is charged with air to expand its diaphragm. When the needle is advanced, the sudden collapse of the diaphragm signals the needle’s penetration into the epidural space, providing a highly specific, positive and visual confirmation that the endpoint has been reached.
At the recent meeting of the American Society of Anesthesiologists, data was released that suggested that this device significantly increased success rates for inexperienced operators. There was also a significant reduction in the number of attempts, number of false positive signals, ease of technique, and confidence in end-point.
While the device didn’t show a statistically significant difference in epidural failure rates, this could be a powerful teaching tool for beginning anesthesiology residents.
Abstract: Randomised Clinical Trial of a New Device for Identification of the Epidural Space
Product page: Epidrum…
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