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Anesth Analg 2004;99:1272
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000134772.60519.96

LETTERS TO THE EDITOR

The Effects of Epidural Needle Rotation

Jeffrey S. Lee, MD

LAC+USC Medical Center, Women’s & Children’s Hospital, Los Angeles, CA, dchavez@usc.edu

To the Editor:

I read with interest the excellent study of Borghi et al. (1). They make no mention of the position in which they placed their patients for epidural catheter insertion. Were all patients placed with the operative side dependent or sitting or were they positioned randomly? Also, did they really use 2–5 mg of phenylephrine for blood pressure rescue?

Reference

  1. Borghi B, Agnoletti V, Ricci A, et al. A prospective, randomized evaluation of the effects of epidural needle rotation on the distribution of epidural block. Anesth Analg 2004; 98: 1473–8.[Abstract/Free Full Text]
 

Response

Andrea Casati, MD, and Battista Borghi, MD

Vita-Salute University of Milano, IRCCS H San Raffaele, Milano, Italy IRCCS Istituti Ortopedici Rizzoli, Bologna, Italy

In Response:

We were pleased to read the comments Dr. Lee made regarding our recently published article, even more so because it allows us to correct a couple of omissions in our study.

In fact, all epidural puncture were performed with the patient in the sitting position, and after epidural catheter insertion they were placed supine.

Concerning the vasoconstrictor, we did not use phenylephrine but etilephrine (Effortil, Boehringer Ingelheim, Milan, Italy) 2–5 mg IV. This vasoconstrictive agent is not marketed in the United States but is routinely used in Italy.





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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