Pseudo loss of resistance in epidural space localization
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Loss of resistance (LOR) is the most commonly used technique to locate the epidural space.[1] LOR to air or saline is often used and is accurate in identifying epidural space in most of the patients. False positive or pseudo-LOR can occur if the needle enters paraspinous muscles or a small cyst in the ligamentum flavum or the interspinous ligaments.[2] However, the exact incidence of false positive LOR is not reported in the literature. We encountered a false positive LOR in a patient with subcutaneous emphysema secondary to chest trauma.
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[3] N. Sharrock. Recordings of, and an anatomical explanation for, false positive loss of resistance during lumbar extradural analgesia. , 1979, British journal of anaesthesia.
[4] S. Kapral,et al. Ultrasound guidance in regional anaesthesia. , 2005, British journal of anaesthesia.