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Additional Advantages of a Two-person Technique for Epidural Needle Placement and Medication Infusion
  1. Angelo G. Rocco, M.D. and
  2. Diane Palombi, R.N., B.S.N.
  1. Pain Treatment Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts


Eight years' experience with the two-person technique has revealed further advantages. A glass syringe and extension tubing filled with saline are connected to the epidural needle. A small bubble of air remains in the syringe but not in the tubing. One person concentrates on the advancement of the needle. The second person exerts sufficient pressure on the plunger of the syringe to produce intermittent minimal flow of saline. The effect is that of barbotage. In several instances the saline at needle end of the tubing unexpectedly became opaque or discolored. The advantages are attributable to the small volume of the extension tubing filled with saline.

  • Anesthesia technique
  • epidural space identification
  • complications

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