Epidural Images
Welcome to the centre, where you can find many examples of failed or complicated epidural blocks, particularly affecting obstetric patients. A normal block is shown for comparison.
Click on the list to the left to access the images.
Technical details:
These epidurograms were created immediately following the injection of approximately 10 ml of contrast, usually Iohexol 320. Anteroposterior (AP) and lateral (LAT) radiographs were then taken and video recordings made.
The contrast may appear as black or white, to reproduce the best clarity.
For more information, contact:
Dr Clive Collier,
MD,MRCP,FRCA,FANZCA
Dr. Clive Collier is an obstetric anaethetist at the Prince of Wales Private Hospital in Sydney.
References:
1. COLLIER CB. Why obstetric epidurals fail. Int J Obstet Anesth 1996; 5:19-31.
2. COLLIER CB. An atlas of epidurograms; epidural blocks investigated. Harwood Academic (Amsterdam) 1998. (Present publisher, Taylor & Francis UK)
3. COLLIER CB. Accidental subdural injection during attempted lumbar epidural block may present as a failed or inadequate block; radiographic evidence. Regional Anesthesia and Pain Medicine 2004; 29:45-51
4. COLLIER CB. Total spinal block via a subdural catheter. Regional Anesthesia and Pain Medicine 2006; 31:181
5. COLLIER CB. Most reported subdural injections are not in the subdural space, they are intradural! Regional Anesthesia and Pain Medicine 2009; 34:613-615
6. COLLIER CB. The intradural space; the fourth place to go astray during epidural block. International Journal of Obstetric Anesthesia 2010; 19;133-141
7. COLLIER CB, REINA MA. Does an intradural space really exist? In reply;
International Journal of Obstetric Anesthesia 2011; 20:89-90
8. COLLIER CB. Blood patches may cause significant scarring in the epidural space: two case reports International Journal of Obstetric Anesthesia 2011;20:347-351
9. REINA MA, COLLIER CB, PRATS-GALINO A, MACHES F, DE ANDRES JA. Accidental subdural placement of epidural catheters during attempted epidural anesthesia. An anatomic of spinal subdural compartment. Regional Anesthesia Pain Medicine - 2011; 36:537-541
10. COLLIER CB, REINA MA, PRATS-GALINO A, MACHÉS F. An anatomical study of the intradural space. Anaesthesia and Intensive Care 2011; 39:1038-1042
11. COLLIER CB. Epidural Images: Problems and Solutions. Hodder Arnold,London, UK 2011