Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo<sup>®</sup>): A Report of 600 Consecutive Cases

Abstract

Introduction. The aim of this open, prospective, single operator study was to report the clinical experience with the CompuFlo? Epidural Instrument. Method. Epidural block was performed with the CompuFlo? Epidural Instrument in all consecutive patients undergoing an epidural or thoracic block under the author’s care over a two years period. The epidural needle was considered to have reached the epidural space when an increase in pressure (accompanied by an increase of the pitch of the audible tone) was followed by a sudden and sustained drop in pressure of more than 5 seconds accompanied by a sudden decrease of the pitch of the audible tone, resulting in the formation of a low and stable pressure plateau on the instrument’s visual display. The following outcomes were evaluated: incidence of accidental dural puncture, success of anesthesia, procedure time, volume of saline used for the epidural procedure, number of epidural attempts to reach the epidural space, number of needle redirections, and the operator’s agreement with his tactile sensation of loss of resistance and the CompuFlo? pattern. Results. A total of 600 cases were studied. All the epidural blocks were successful and no accidental dural punctures were noted. Epidural space was correctly identified on the first attempt in 91% of cases, in 95% of cases the operator judged as a perfect correlation between his tactile sensations and the CompuFlo? recordings. Conclusion. The major finding of this paper is the very high success rate of the epidural blocks, no matter in what clinical setting (obstetrical, surgical or blood patch intervention) or at which vertebral level (thoracic or epidural) were done. Most importantly, the reporting of zero incidence of any accidental dural puncture.