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The Accuracy of Using Thiopental or Test Strips to Detect Dural Puncture During Continuous Epidural Analgesia
  1. William E. Ackerman, MD,
  2. Mustaque M. Juneja, MD,
  3. David M. Kaczorowski, DO,
  4. Donald D. Denson, PhD,
  5. Umeshraya T. Pai, MD,
  6. Carolyn J. Nicholson, CRNA and
  7. Phillip O. Bridenbaugh, MD
  1. From the Department of Anesthesia, University of Cincinnati College of Medicine, Cincinnati, Ohio


An epidural catheter may puncture the dura during insertion or patient movement. When one is able to obtain free-flowing fluid, thiopental or pH urine test strips are helpful in distinguishing cerebrospinal fluid from local anesthetic or saline. However, one cannot always obtain free-flowing fluid from an epidural catheter and, in some instances, one can only obtain several drops of epidural aspirate. If only a few drops are obtained, the aspirate will contain a large percentage of the solution injected. This study demonstrates the usefulness of glucose test strips in detecting small volumes of cerebrospinal fluid diluted with saline or local anesthetics.

  • Test strips
  • dural tear
  • Thiopental

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