Advertisement

An observational pilot study of a novel loss of resistance syringe for locating the epidural space

Published:March 26, 2021DOI:https://doi.org/10.1016/j.ijoa.2021.102984

      Highlights

      • EpiFaith™ is a novel loss of resistance syringe for locating the epidural space.
      • The EpiFaith™ signals when there is a loss of resistance.
      • We report on the clinical use of the EpiFaith™ loss of resistance syringe.
      • Three of four anesthesiologists rated it more highly than using their usual syringe.

      Abstract

      Background

      The EpiFaith® syringe is a novel loss-of-resistance syringe that utilizes a spring-loaded plunger that automatically moves forward within the syringe when there is a loss of resistance. We evaluated the syringe in a clinical setting among a cohort of pregnant women receiving neuraxial labor analgesia.

      Methods

      In a non-randomized observational study, four anesthesiologists used the EpiFaith® syringe 10 times each while placing epidural catheters for labor analgesia. The anesthesiologists scored each placement on an 11-point Likert scale (−5 = absolutely worse, 0 = the same, and 5 = absolutely better than using their regular loss-of-resistance syringe technique).

      Results

      All 40 neuraxial placements correctly located the epidural space. Air was used in the syringe in 35 of the 40 cases. In 50%, 27.5% and 22.5% of cases the anesthesiologists reported that using the EpiFaith® syringe was better than, the same as, or worse than using their regular syringe, respectively. There were no inadvertent dural punctures.

      Conclusions

      This feasibility study found that three of the four anesthesiologists scored the EpiFaith® syringe as better or the same as using their regular loss-of-resistance syringe. More extensive studies are required to determine if the EpiFaith® syringe reduces adverse outcomes such as unintentional dural punctures.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to International Journal of Obstetric Anesthesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Riley E.T.
        • Carvalho B.
        The Episure syringe: a novel loss of resistance syringe for locating the epidural space.
        Anesth Analg. 2007; 105: 1164-1166
        • Chau A.
        • Bibbo C.
        • Huang C.C.
        • et al.
        Dural puncture epidural technique improves labor analgesia quality with fewer side effects compared with epidural and combined spinal epidural techniques: a randomized clinical trial.
        Anesth Analg. 2017; 124: 560-569
        • Carabuena J.M.
        • Mitani A.M.
        • Liu X.
        • Kodali B.S.
        • Tsen L.C.
        The learning curve associated with the epidural technique using the Episure™ AutoDetect™ versus conventional glass syringe: an open-label, randomized, controlled, crossover trial of experienced anesthesiologists in obstetric patients.
        Anesth Analg. 2013; 116: 145-154
        • Habib A.S.
        • George R.B.
        • Allen T.K.
        • Olufolabi A.J.
        A pilot study to compare the Episure™ Autodetect™ syringe with the glass syringe for identification of the epidural space in parturients.
        Anesth Analg. 2008; 106: 541-543