Epidural technique has become a part of anaesthetists armamentarium. But mastering it requires a long learning curve. Moreover, the procedure has to be foolproof. So we want to use pressure as a guiding force to identify the epidural space. Primary objective:To identify the epidural space with the new method and confirm the result with the gold standard which is loss of resistance to saline.

We got institutional ethics committee approval for the study. Patients requiring epidural analgesia were recruited for the study and got consent after explaining the procedure. Having obtained an intravenous access and hooking the patient to mandatory monitor, patients were sat up with legs hanging down the operating table. The procedure was done in an aseptic manner. We used a sterile, freshly opened transducer (normally used for measuring the central venous pressure). The tip of the transducer line is attached to the hub of the epidural needle and flushed. The transducer is zeroed at the level of needle insertion. By looking at the monitor displaying the pressure reading, the needle was advanced. The pressure kept increasing as the needle was advanced. At one point, the pressure reading drops steeply from a very high value to a very low value ie from a reading of 250 mmHg to 10 mmHg. At this point, the transducer was disconnected from the needle and 10 ml of saline was flushed into the space to confirm it. Then catheter was threaded and pressure was measured at the catheter tip.

20 patients were done as part of a pilot study. The epidural space was identified in all the patients correctly. The catheters worked as well.The results were encouraging.

To conclude, the new technique worked well with experienced anaesthetist. This new technique will help the freshers to learn the technique with confide