{"id":"https://openalex.org/W2070530751","doi":"https://doi.org/10.1213/01.ane.0000120084.56136.15","title":"Identification of the Epidural Space: Loss of Resistance with Air, Lidocaine, or the Combination of Air and Lidocaine","display_name":"Identification of the Epidural Space: Loss of Resistance with Air, Lidocaine, or the Combination of Air and Lidocaine","publication_year":2004,"publication_date":"2004-07-01","ids":{"openalex":"https://openalex.org/W2070530751","doi":"https://doi.org/10.1213/01.ane.0000120084.56136.15","mag":"2070530751","pmid":"https://pubmed.ncbi.nlm.nih.gov/15281538"},"language":"en","primary_location":{"id":"doi:10.1213/01.ane.0000120084.56136.15","doi":"https://doi.org/10.1213/01.ane.0000120084.56136.15","is_oa":false,"landing_page_url":"https://doi.org/10.1213/01.ane.0000120084.56136.15","pdf_url":null,"source":{"id":"https://openalex.org/S104698359","display_name":"Anesthesia & Analgesia","issn_l":"0003-2999","issn":["0003-2999","1526-7598"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Anesthesia &amp; Analgesia","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5022318340","display_name":"S Evron","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I142740786","display_name":"University of Louisville","ror":"https://ror.org/01ckdn478","country_code":"US","type":"education","lineage":["https://openalex.org/I142740786"]},{"id":"https://openalex.org/I16391192","display_name":"Tel Aviv University","ror":"https://ror.org/04mhzgx49","country_code":"IL","type":"education","lineage":["https://openalex.org/I16391192"]},{"id":"https://openalex.org/I2800717019","display_name":"Wolfson Medical Center","ror":"https://ror.org/04ayype77","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2800717019"]}],"countries":["IL","US"],"is_corresponding":true,"raw_author_name":"Samuel Evron","raw_affiliation_strings":["*Obstetric Anesthesia Unit, \u2021Department of Obstetrics and Gynecology, \u00a7Epidemiology Unit, and ||Department of Anesthesia, The Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel; and \u2020Outcomes Research\u2122 Institute and Departments of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky","University of Louisville, Louisville, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"*Obstetric Anesthesia Unit, \u2021Department of Obstetrics and Gynecology, \u00a7Epidemiology Unit, and ||Department of Anesthesia, The Edith Wolfson Medical Center, Holon, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel; and \u2020Outcomes Research\u2122 Institute and Departments of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky","institution_ids":["https://openalex.org/I142740786","https://openalex.org/I16391192","https://openalex.org/I2800717019"]},{"raw_affiliation_string":"University of Louisville, Louisville, United States","institution_ids":["https://openalex.org/I142740786"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5042996287","display_name":"Daniel I. Sessler","orcid":"https://orcid.org/0000-0001-9932-3077","observed_orcids":["https://orcid.org/0000-0001-9932-3077"]},"institutions":[{"id":"https://openalex.org/I142740786","display_name":"University of Louisville","ror":"https://ror.org/01ckdn478","country_code":"US","type":"education","lineage":["https://openalex.org/I142740786"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Daniel Sessler","raw_affiliation_strings":["Outcomes Research\u2122 Institute and Departments of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky","and \u00a7Outcomes Research\u2122 Institute and Departments of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Outcomes Research\u2122 Institute and Departments of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky","institution_ids":["https://openalex.org/I142740786"]},{"raw_affiliation_string":"and \u00a7Outcomes Research\u2122 Institute and Departments of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky","institution_ids":["https://openalex.org/I142740786"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058084162","display_name":"Oscar Sadan","orcid":"https://orcid.org/0000-0002-1969-6533","observed_orcids":["https://orcid.org/0000-0002-1969-6533"]},"institutions":[{"id":"https://openalex.org/I16391192","display_name":"Tel Aviv University","ror":"https://ror.org/04mhzgx49","country_code":"IL","type":"education","lineage":["https://openalex.org/I16391192"]},{"id":"https://openalex.org/I2800717019","display_name":"Wolfson Medical Center","ror":"https://ror.org/04ayype77","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2800717019"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Oscar Sadan","raw_affiliation_strings":["Edith Wolfson Medical Center Israel","Tel Aviv University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edith Wolfson Medical Center Israel","institution_ids":["https://openalex.org/I2800717019"]},{"raw_affiliation_string":"Tel Aviv University","institution_ids":["https://openalex.org/I16391192"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5000594292","display_name":"Mona Boaz","orcid":"https://orcid.org/0000-0002-3920-7549","observed_orcids":["https://orcid.org/0000-0002-3920-7549"]},"institutions":[{"id":"https://openalex.org/I16391192","display_name":"Tel Aviv University","ror":"https://ror.org/04mhzgx49","country_code":"IL","type":"education","lineage":["https://openalex.org/I16391192"]},{"id":"https://openalex.org/I2800717019","display_name":"Wolfson Medical Center","ror":"https://ror.org/04ayype77","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2800717019"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Mona Boaz","raw_affiliation_strings":["Edith Wolfson Medical Center Israel","Tel Aviv University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edith Wolfson Medical Center Israel","institution_ids":["https://openalex.org/I2800717019"]},{"raw_affiliation_string":"Tel Aviv University","institution_ids":["https://openalex.org/I16391192"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5041578969","display_name":"Marek Glezerman","orcid":"https://orcid.org/0000-0002-9175-2253","observed_orcids":["https://orcid.org/0000-0002-9175-2253"]},"institutions":[{"id":"https://openalex.org/I16391192","display_name":"Tel Aviv University","ror":"https://ror.org/04mhzgx49","country_code":"IL","type":"education","lineage":["https://openalex.org/I16391192"]},{"id":"https://openalex.org/I2800717019","display_name":"Wolfson Medical Center","ror":"https://ror.org/04ayype77","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2800717019"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Marek Glezerman","raw_affiliation_strings":["Edith Wolfson Medical Center Israel","Tel Aviv University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edith Wolfson Medical Center Israel","institution_ids":["https://openalex.org/I2800717019"]},{"raw_affiliation_string":"Tel Aviv University","institution_ids":["https://openalex.org/I16391192"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5060902396","display_name":"Tiberiu Ezri","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I16391192","display_name":"Tel Aviv University","ror":"https://ror.org/04mhzgx49","country_code":"IL","type":"education","lineage":["https://openalex.org/I16391192"]},{"id":"https://openalex.org/I2800717019","display_name":"Wolfson Medical Center","ror":"https://ror.org/04ayype77","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2800717019"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Tiberiu Ezri","raw_affiliation_strings":["Edith Wolfson Medical Center Israel","Tel Aviv University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edith Wolfson Medical Center Israel","institution_ids":["https://openalex.org/I2800717019"]},{"raw_affiliation_string":"Tel Aviv University","institution_ids":["https://openalex.org/I16391192"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5022318340"],"corresponding_institution_ids":["https://openalex.org/I142740786","https://openalex.org/I16391192","https://openalex.org/I2800717019"],"apc_list":null,"apc_paid":null,"fwci":6.9677,"has_fulltext":false,"cited_by_count":73,"citation_normalized_percentile":{"value":0.9721911,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"99","issue":"1","first_page":"245","last_page":"250"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10189","display_name":"Anesthesia and Pain Management","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10189","display_name":"Anesthesia and Pain Management","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11199","display_name":"Pain Management and Opioid Use","score":0.0007999999797903001,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11840","display_name":"Pain Management and Treatment","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/epidural-space-identification","display_name":"epidural space identification","score":0.9700000286102295},{"id":"https://openalex.org/keywords/epidural-analgesia","display_name":"epidural analgesia","score":0.703000009059906},{"id":"https://openalex.org/keywords/labor","display_name":"labor","score":0.5839999914169312},{"id":"https://openalex.org/keywords/epidural-catheter-placement","display_name":"epidural catheter placement","score":0.925000011920929},{"id":"https://openalex.org/keywords/accidental-dural-puncture","display_name":"accidental dural puncture","score":0.9340000152587891},{"id":"https://openalex.org/keywords/epidural-anesthesia","display_name":"epidural anesthesia","score":0.4699999988079071},{"id":"https://openalex.org/keywords/post-dural-puncture-headache","display_name":"post-dural puncture headache","score":0.8529999852180481},{"id":"https://openalex.org/keywords/postpartum-urinary-retention","display_name":"postpartum urinary retention","score":0.6309999823570251},{"id":"https://openalex.org/keywords/hypotension","display_name":"hypotension","score":0.6660000085830688}],"concepts":[{"id":"https://openalex.org/C2780149897","wikidata":"https://www.wikidata.org/wiki/Q216935","display_name":"Lidocaine","level":2,"score":0.9381732940673828},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.853512704372406},{"id":"https://openalex.org/C2777657843","wikidata":"https://www.wikidata.org/wiki/Q3966104","display_name":"Epidural space","level":2,"score":0.7756612300872803},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.7673255205154419},{"id":"https://openalex.org/C2778994108","wikidata":"https://www.wikidata.org/wiki/Q1868462","display_name":"Local anesthetic","level":2,"score":0.505748987197876},{"id":"https://openalex.org/C2781267111","wikidata":"https://www.wikidata.org/wiki/Q652297","display_name":"Catheter","level":2,"score":0.48670414090156555},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.461681067943573},{"id":"https://openalex.org/C2777276199","wikidata":"https://www.wikidata.org/wiki/Q1346981","display_name":"Tuohy needle","level":4,"score":0.43897518515586853},{"id":"https://openalex.org/C2776651062","wikidata":"https://www.wikidata.org/wiki/Q2143681","display_name":"Seldinger technique","level":3,"score":0.0}],"mesh":[{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000388","descriptor_name":"Air","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000767","descriptor_name":"Anesthesia, Epidural","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D000779","descriptor_name":"Anesthetics, Local","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004311","descriptor_name":"Double-Blind Method","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004824","descriptor_name":"Epidural Space","qualifier_ui":"Q000033","qualifier_name":"anatomy & histology","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008012","descriptor_name":"Lidocaine","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D010147","descriptor_name":"Pain Measurement","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011247","descriptor_name":"Pregnancy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011312","descriptor_name":"Pressure","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013594","descriptor_name":"Syringes","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016058","descriptor_name":"Analgesia, Patient-Controlled","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1213/01.ane.0000120084.56136.15","doi":"https://doi.org/10.1213/01.ane.0000120084.56136.15","is_oa":false,"landing_page_url":"https://doi.org/10.1213/01.ane.0000120084.56136.15","pdf_url":null,"source":{"id":"https://openalex.org/S104698359","display_name":"Anesthesia & Analgesia","issn_l":"0003-2999","issn":["0003-2999","1526-7598"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Anesthesia &amp; Analgesia","raw_type":"journal-article"},{"id":"pmid:15281538","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/15281538","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Anesthesia and analgesia","raw_type":"Clinical Trial"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/randomized-controlled-trial","display_name":"Randomized Controlled Trial"},{"id":"https://openalex.org/study-designs/clinical-trial","display_name":"Clinical Trial"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":30,"referenced_works":["https://openalex.org/W207030221","https://openalex.org/W1556432401","https://openalex.org/W1969102909","https://openalex.org/W1976595547","https://openalex.org/W1990093525","https://openalex.org/W1995617292","https://openalex.org/W1997504880","https://openalex.org/W2000932330","https://openalex.org/W2003945743","https://openalex.org/W2007917752","https://openalex.org/W2011662053","https://openalex.org/W2038868107","https://openalex.org/W2047782501","https://openalex.org/W2048120937","https://openalex.org/W2050689458","https://openalex.org/W2061116779","https://openalex.org/W2062517115","https://openalex.org/W2078606125","https://openalex.org/W2085298760","https://openalex.org/W2092459455","https://openalex.org/W2100883552","https://openalex.org/W2105354984","https://openalex.org/W2105722402","https://openalex.org/W2120546421","https://openalex.org/W2125053049","https://openalex.org/W2138708288","https://openalex.org/W2160242543","https://openalex.org/W2172021322","https://openalex.org/W3039952183","https://openalex.org/W4253950319"],"related_works":["https://openalex.org/W2055551856","https://openalex.org/W2588568482","https://openalex.org/W2890987997","https://openalex.org/W4399307882","https://openalex.org/W2309230915","https://openalex.org/W2145917275","https://openalex.org/W2574677938","https://openalex.org/W2148207021","https://openalex.org/W2756010253","https://openalex.org/W2319592450"],"abstract_inverted_index":{"The":[0,79,123],"ideal":[1],"technique":[2,27],"for":[3],"identifying":[4],"the":[5,26,30,72,83,90,94,99,108,132,139,159,177],"epidural":[6,16,31,67,84,178],"space":[7,32,179],"remains":[8],"unclear.":[9],"Five-hundred-forty-seven":[10],"women":[11],"in":[12,87,131,138],"labor":[13],"who":[14],"requested":[15],"analgesia":[17],"were":[18,173],"randomly":[19],"allocated":[20],"to":[21,25,81,149],"three":[22],"groups":[23],"according":[24],"by":[28],"which":[29],"was":[33,129,182],"identified:":[34],"1)":[35],"loss-of-resistance":[36,44,53],"with":[37,45,54,180,191],"air":[38,56,109,133,181,194,201],"(air;":[39],"n":[40,48,60],"=":[41,49,61],"180),":[42],"2)":[43],"lidocaine":[46,58,192,203,208],"(lidocaine;":[47],"185),":[50],"and":[51,57,77,96,117,158,169,185,202],"3)":[52],"both":[55],"(air-plus-lidocaine;":[59],"182).":[62],"We":[63],"assessed":[64],"ease":[65],"of":[66,71,75,89,93,98,125,151,161,176,200],"catheter":[68,85],"insertion,":[69],"characteristics":[70],"blockade,":[73,157],"quality":[74],"analgesia,":[76,152],"complications.":[78],"inability":[80],"thread":[82],"occurred":[86],"16%":[88],"air,":[91],"4%":[92],"lidocaine,":[95],"3%":[97],"air-plus-lidocaine":[100],"patients":[101,106],"(P":[102],"<":[103,121,144],"0.001).":[104],"More":[105],"from":[107],"group":[110,134],"had":[111,204],"unblocked":[112],"segments":[113],"(6.6%":[114],"versus":[115,136],"3.2%":[116],"2.2%,":[118],"respectively;":[119],"P":[120,143],"0.02).":[122,145],"incidence":[124,160],"accidental":[126],"dural":[127,188],"puncture":[128,171],"greater":[130],"(1.7%":[135],"0%":[137],"other":[140],"two":[141],"groups;":[142],"Pain":[146],"scores,":[147],"time":[148],"onset":[150],"upper":[153],"sensory":[154],"level,":[155],"motor":[156],"hypotension,":[162],"transient":[163],"neurological":[164],"deficits,":[165],"postpartum":[166],"urinary":[167],"retention,":[168],"postdural":[170],"headache":[172],"comparable.":[174],"Identification":[175],"more":[183,187],"difficult":[184],"caused":[186],"punctures":[189],"than":[190],"or":[193],"plus":[195],"lidocaine.":[196],"Additionally,":[197],"sequential":[198],"use":[199],"no":[205],"advantage":[206],"over":[207],"alone.":[209]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":2},{"year":2024,"cited_by_count":1},{"year":2023,"cited_by_count":1},{"year":2022,"cited_by_count":1},{"year":2020,"cited_by_count":2},{"year":2018,"cited_by_count":3},{"year":2017,"cited_by_count":2},{"year":2016,"cited_by_count":2},{"year":2015,"cited_by_count":1},{"year":2014,"cited_by_count":5},{"year":2013,"cited_by_count":1},{"year":2012,"cited_by_count":7}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}