Dogliotti's principle

Dogliotti's principle is a principle in epidural anaesthesia first described by Professor Achille Mario Dogliotti in 1933.^[1] It is a method for the identification of the epidural space, a potential space. As a needle is advanced through the ligamentum flavum, to the epidural space, with constant pressure applied to the piston of a syringe, loss of resistance occurs once the needle enters the subdural space due to the change in pressure.^[2][3] The identification of this space, allows subsequent administration of epidural anaesthesia, a technique used primarily for analgesia during childbirth.

This technique remains in use at present^[update], and is commonly referred to the loss of resistance to saline technique (LORS) or its variation, the loss of resistance to air technique (LORA). These use, respectively, saline or air to identify the epidural space. The LORS technique is generally favoured due to the increased complication risk with the LORA technique such as pneumocephalus or air embolism.^[3][4][5]

See also

• Epidural procedure
• Odom's indicator

References

1. ^ Dogliotti AM (1933). "Research and Clinical Observations on Spinal Anesthesia: With Special Reference to the Peridural Technique.". Anesthesia and Analgesia 12: 59–65. 
2. ^ Iklé A (July 1950). "Preliminary report of new technique for epidural anaesthesia.". British Journal of Anaesthesia 22 (3): 150–155. doi:10.1093/bja/22.3.150. PMID 15426701. 
3. ^ ^{a b} Wilson MJA (2007). "Epidural endeavour and the pressure principle.". Anaesthesia 62 (4): 319–324. doi:10.1111/j.1365-2044.2007.05063.x. PMID 17381564. 
4. ^ Naultly J. S. et al. (1982). "Incidence of venous air embolism during venous catheter insertion.". Anaethesiology 57 (5): 410–412. doi:10.1097/00000542-198211000-00010. 
5. ^ Simopoulos T. and Peeters-Asdourian C. (2001). "Pneumocephalus after Cervical Epidural Steroid Injection". Anaesthesia and Analgesia 92: 1576–1577.