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Caudal epidurals: the whoosh test

Caudal epidural injection is a simple procedure that carries a low risk of complications. The whoosh test (injection of air into the caudal epidural space with simultaneous auscultation over the thoracolumbar spine) has been recommended as an aid to correct needle placement. A 1-year prospective study, using fluoroscopic imaging to identify needle position, was conducted to compare the sensitivity and specificity of the whoosh test with that of clinical impression alone in assessing correct needle placement in the caudal space. Of 131 patients studied, correct needle placement was achieved in 121 on the first attempt (92%). Clinical impression alone had a sensitivity of 94% and a specificity of 20%. The whoosh test had a sensitivity of 80% and a specificity of 60%. The whoosh test is superior to clinical judgment in detecting incorrect caudal needle placement

Keywords : administration & dosage,Air,Anti-Inflammatory Agents,Auscultation,Cauda Equina,complications,drug therapy,Epidural Space,Fluoroscopy,Humans,Injections,Epidural,Low Back Pain,methods,Patients,Prospective Studies,Risk,Sensitivity and Specificity,Spine,Stethoscopes,therapeutic use,Triamcinolone,, Epidurals,Whoosh,Test, orthopedist job description

Date of Publication : 1998 Mar

Authors : Eastwood D;Williams C;Buchan I;

Organisation : Department of Anaesthetics, Arrowe Park Hospital, Upton, Wirral, Merseyside, UK

Journal of Publication : Anaesthesia

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/9613279

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