Hanging-drop Technique for CESIs

[Nico47]

Yay or nay?

Anyone care to share their experiences with and without? Are there proven benefits to using this method over fluoro-guided cervicals (besides -XR exposure)?

Just curious.

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[lobelsteve]

Yay or nay?

Anyone care to share their experiences with and without? Are there proven benefits to using this method over fluoro-guided cervicals (besides -XR exposure)?

Just curious.

Not using fluoro is not the standard of care.
Blind epidurals are more dangerous and less efficacious.
No one should do these for pain relief.
Ever.

 

[paiute]

as an anesthesiologist, i always used the air in the syringe technique: gently ballot an airfilled, liquid lubricated, glass syringe attached to the Tuohy needle until there is a sudden, "give way" and the air injects (don't inject much air). i saw a "hanging drop" technique used by an attending once and he got a wet tap!

we never used XR. this was both for CESI and epidurals for labor pain/C sections.

 

[paiute]

as an anesthesiologist, i always used the air in the syringe technique: gently ballot an airfilled, liquid lubricated, glass syringe attached to the Tuohy needle until there is a sudden, "give way" and the air injects (don't inject much air). i saw a "hanging drop" technique used by an attending once and he got a wet tap!

we never used XR. this was both for CESI and epidurals for labor pain/C sections.

correction: LESI, not CESI. I never did a CESI for pain. i think too risky. maybe in case of CESI, XR would be good idea.

 

[olafa]

correction: LESI, not CESI. I never did a CESI for pain. i think too risky. maybe in case of CESI, XR would be good idea.

I have seen this used as a resident (anesth attending) - the only reason was that the patient was too ill and literally could NOT lay prone for the procedure and the upright flexed foward position was used the best possible way to complete the procedure. I don't have a large exposure to this technique and I know before fluro this was the "way it was done" but with technology now and the standard of care being to use it- I beleive hanging drop is only done rather as the exception.

 

[PMR 4 MSK]

I like positive pressure via LOR rather than the neutral pressure of hanging drop.