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Use of epidurography in the perioperative and acute pain setting
  1. John Robert Coleman1,
  2. Patrick Hartmann2,
  3. Matthew Kona3,
  4. Robert A Thiele1,
  5. Reza Salajegheh4 and
  6. Neil A Hanson5
  1. 1Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia, USA
  2. 2Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
  3. 3Department of Radiology, Hunter Holmes McGuire Richmond VAMC, Richmond, Virginia, USA
  4. 4Anesthesiology and Pain Medicine, OrthoVirginia Lynchburg, Lynchburg, Virginia, USA
  5. 5Department of Anesthesiology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
  1. Correspondence to Dr John Robert Coleman, Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22903, USA; tku4jx{at}virginia.edu

Abstract

Ensuring proper placement of epidural catheters is critical to improving their reliability for pain control and maintaining confidence in their continued use. This article will seek to address the role of objective confirmation of successful epidural placement via either single view or continuous epidural contrast studies, each creating an ‘epidurogram.’ Furthermore, the pertinent anatomical corollaries of continuous fluoroscopy used frequently in chronic pain medicine, from which these techniques emerged, will be addressed. Technical radiographic information needed to better understand and troubleshoot these studies is also included. Image examples which highlight the patterns key for successful interpretation of epidurograms will be provided. The aim of this paper was to provide an anesthesiologist unfamiliar with fluoroscopic evaluation of epidural catheters with the tools necessary to successfully conduct and interpret such an examination.

  • Pain, Postoperative
  • Pain Management
  • Diagnostic Techniques and Procedures
  • Acute Pain
  • REGIONAL ANESTHESIA

Data availability statement

Data sharing not applicable as no datasets were generated and/or analyzed for this study. This article serves as an educational article and does not include the implementation or analysis of novel datasets. As such, no datasets were generated or analyzed for this publication.

https://doi.org/10.1136/rapm-2021-103274

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    Data availability statement

    Data sharing not applicable as no datasets were generated and/or analyzed for this study. This article serves as an educational article and does not include the implementation or analysis of novel datasets. As such, no datasets were generated or analyzed for this publication.

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    Footnotes

    • Contributors All authors assisted in the design and contributed to the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.