Epidural advices

[DrN2O]

I just need some input on some specific questions about epidural, and want to tap into the wealth of diverse knowledge here.

1. Can I let go of the tuohy after I get LOR and before the catheter?
2. Who uses the hanging drop? I've seen it works beautifully, but some people claim it's prone to skin plug or is just a bad old technique.
3. Do you still inject saline after the hanging drop to dilate the space before threading?
4. Is it really necessary to do paramedian approach if you are not at T6-T10?
5. How come I can never hit the lamina with my finder needle with paramedian approach? Too lateral? Too low or too high relative to the spineous process?

Thanks.

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[Bertelman]

I just need some input on some specific questions about epidural, and want to tap into the wealth of diverse knowledge here.

1. Can I let go of the tuohy after I get LOR and before the catheter?
2. Who uses the hanging drop? I've seen it works beautifully, but some people claim it's prone to skin plug or is just a bad old technique.
3. Do you still inject saline after the hanging drop to dilate the space before threading?
4. Is it really necessary to do paramedian approach if you are not at T6-T10?
5. How come I can never hit the lamina with my finder needle with paramedian approach? Too lateral? Too low or too high relative to the spineous process?

Thanks.

1 yes
2 not me
3 i presume so
4 it's never "necessary", just easier. you can do paramedian in the lumbar space if you're having trouble with midline
5 i don't know. What kind of "finder needle" are you using? you mean the local needle?