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Anesth Analg 2003;96:1183-1187
© 2003 International Anesthesia Research Society

REGIONAL ANESTHESIA

Clinical Results with the Acoustic Puncture Assist Device, a New Acoustic Device to Identify the Epidural Space

Timo J. Lechner, MD*, Maarten G. van Wijk, MD*, Ad J. Maas, PhD{dagger}, Frank R. van Dorsten, MD*, Ronald A. Drost, MD*, Chris J. Langenberg, MD*, Leo J. Teunissen, MD*, Paul H. Cornelissen, MD*, and Jan van Niekerk, PhD*

Departments of *Anesthesiology and Pain Therapy and {dagger}Clinical Physics, Jeroen Bosch Ziekenhuis, ‘s-Hertogenbosch, The Netherlands

Address correspondence to Timo J. Lechner, Department of Anesthesiology and Pain Therapy, Jeroen Bosch Ziekenhuis, Nieuwstraat 34, 5200 ME ‘s-Hertogenbosch, The Netherlands. Address e-mail to anesthesie{at}boschmedicentrum.nl Reprints will not be available from the author.

Sixty patients scheduled for lumbar epidural anesthesia were included in a study in which we evaluated the efficacy of localizing the epidural space by means of an acoustic signal. A prototype of an acoustic puncture assist device, connected to the epidural needle by an extension tube, generated the pressure needed to perform the epidural puncture and translated this pressure into corresponding acoustic and visible signals. The device frees the anesthesiologist to handle the epidural needle with both hands and to detect the epidural space by means of these signals. In all 60 patients (100%), the epidural space was successfully located by using the acoustic signal. In all cases, this was confirmed by the pressure measurement, which proved to be a reliable indicator for correct identification of the epidural space. We conclude that it is possible to locate the epidural space by means of the acoustic puncture assist device. The method proved to be reliable, safe, and simple in this study. The benefits of this new epidural puncture technique include better needle control, teaching, control of correct catheter placement, and documentation. The last can be an important adjunct to anesthesia practice.

IMPLICATIONS: The authors demonstrate that it is possible to identify the epidural space by an acoustic and visible signal. An experimental setup constructed for this purpose makes the epidural puncture procedure audible and visible.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2003 by the International Anesthesia Research Society.