An observational cohort study of the meniscus test to detect intravascular epidural catheters in pregnant women

Abstract Background The meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while physically manipulating the catheter. The aim of this study was to assess whether the meniscus test improves diagnostic accuracy of aspirati...

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Published inInternational journal of obstetric anesthesia Vol. 18; no. 3; pp. 215 - 220
Main Authors Servin, M.N, Mhyre, J.M, Greenfield, M.L.V.H, Polley, L.S
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.07.2009
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Abstract Abstract Background The meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while physically manipulating the catheter. The aim of this study was to assess whether the meniscus test improves diagnostic accuracy of aspiration to detect intravascular or intrathecal placement of epidural catheters in pregnant women. Methods In this prospective observational study, parturients at ⩾36 weeks of gestation were recruited. In the sitting position, participants received a multiorifice epidural catheter for elective cesarean delivery or labor analgesia. After aspiration was confirmed to be negative for blood and cerebrospinal fluid, the meniscus test was performed. Subsequently, a pharmacologic test dose was given with 1.5% lidocaine 3 mL and epinephrine 15 μg. Intravascular placement was diagnosed if the patient experienced an increase in heart rate ⩾20 beats/min within 2 min with or without tinnitus, metallic taste, dizziness, palpitations, headache, or anxiety. Results The overall intravascular catheter rate was 5.7% (24/419). The rate of intravascular catheter location not detected by aspiration was 0.95% (4/419). Given negative catheter aspiration, the meniscus test demonstrated 25% sensitivity, 87.5% specificity, and 1.9% positive predictive value for intravascular catheter insertion. No intrathecal catheters were observed. Conclusions For obstetric patients in the sitting position, the meniscus test does not improve diagnostic accuracy of aspiration for detecting intravascular multiorifice epidural catheter placement.
AbstractList The meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while physically manipulating the catheter. The aim of this study was to assess whether the meniscus test improves diagnostic accuracy of aspiration to detect intravascular or intrathecal placement of epidural catheters in pregnant women. In this prospective observational study, parturients at ⩾36 weeks of gestation were recruited. In the sitting position, participants received a multiorifice epidural catheter for elective cesarean delivery or labor analgesia. After aspiration was confirmed to be negative for blood and cerebrospinal fluid, the meniscus test was performed. Subsequently, a pharmacologic test dose was given with 1.5% lidocaine 3 mL and epinephrine 15 μg. Intravascular placement was diagnosed if the patient experienced an increase in heart rate ⩾20 beats/min within 2 min with or without tinnitus, metallic taste, dizziness, palpitations, headache, or anxiety. The overall intravascular catheter rate was 5.7% (24/419). The rate of intravascular catheter location not detected by aspiration was 0.95% (4/419). Given negative catheter aspiration, the meniscus test demonstrated 25% sensitivity, 87.5% specificity, and 1.9% positive predictive value for intravascular catheter insertion. No intrathecal catheters were observed. For obstetric patients in the sitting position, the meniscus test does not improve diagnostic accuracy of aspiration for detecting intravascular multiorifice epidural catheter placement.
BACKGROUNDThe meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while physically manipulating the catheter. The aim of this study was to assess whether the meniscus test improves diagnostic accuracy of aspiration to detect intravascular or intrathecal placement of epidural catheters in pregnant women.METHODSIn this prospective observational study, parturients at >or= 36 weeks of gestation were recruited. In the sitting position, participants received a multiorifice epidural catheter for elective cesarean delivery or labor analgesia. After aspiration was confirmed to be negative for blood and cerebrospinal fluid, the meniscus test was performed. Subsequently, a pharmacologic test dose was given with 1.5% lidocaine 3 mL and epinephrine 15 microg. Intravascular placement was diagnosed if the patient experienced an increase in heart rate >or= 20 beats/min within 2 min with or without tinnitus, metallic taste, dizziness, palpitations, headache, or anxiety.RESULTSThe overall intravascular catheter rate was 5.7% (24/419). The rate of intravascular catheter location not detected by aspiration was 0.95% (4/419). Given negative catheter aspiration, the meniscus test demonstrated 25% sensitivity, 87.5% specificity, and 1.9% positive predictive value for intravascular catheter insertion. No intrathecal catheters were observed.CONCLUSIONSFor obstetric patients in the sitting position, the meniscus test does not improve diagnostic accuracy of aspiration for detecting intravascular multiorifice epidural catheter placement.
Abstract Background The meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while physically manipulating the catheter. The aim of this study was to assess whether the meniscus test improves diagnostic accuracy of aspiration to detect intravascular or intrathecal placement of epidural catheters in pregnant women. Methods In this prospective observational study, parturients at ⩾36 weeks of gestation were recruited. In the sitting position, participants received a multiorifice epidural catheter for elective cesarean delivery or labor analgesia. After aspiration was confirmed to be negative for blood and cerebrospinal fluid, the meniscus test was performed. Subsequently, a pharmacologic test dose was given with 1.5% lidocaine 3 mL and epinephrine 15 μg. Intravascular placement was diagnosed if the patient experienced an increase in heart rate ⩾20 beats/min within 2 min with or without tinnitus, metallic taste, dizziness, palpitations, headache, or anxiety. Results The overall intravascular catheter rate was 5.7% (24/419). The rate of intravascular catheter location not detected by aspiration was 0.95% (4/419). Given negative catheter aspiration, the meniscus test demonstrated 25% sensitivity, 87.5% specificity, and 1.9% positive predictive value for intravascular catheter insertion. No intrathecal catheters were observed. Conclusions For obstetric patients in the sitting position, the meniscus test does not improve diagnostic accuracy of aspiration for detecting intravascular multiorifice epidural catheter placement.
The meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while physically manipulating the catheter. The aim of this study was to assess whether the meniscus test improves diagnostic accuracy of aspiration to detect intravascular or intrathecal placement of epidural catheters in pregnant women. In this prospective observational study, parturients at >or= 36 weeks of gestation were recruited. In the sitting position, participants received a multiorifice epidural catheter for elective cesarean delivery or labor analgesia. After aspiration was confirmed to be negative for blood and cerebrospinal fluid, the meniscus test was performed. Subsequently, a pharmacologic test dose was given with 1.5% lidocaine 3 mL and epinephrine 15 microg. Intravascular placement was diagnosed if the patient experienced an increase in heart rate >or= 20 beats/min within 2 min with or without tinnitus, metallic taste, dizziness, palpitations, headache, or anxiety. The overall intravascular catheter rate was 5.7% (24/419). The rate of intravascular catheter location not detected by aspiration was 0.95% (4/419). Given negative catheter aspiration, the meniscus test demonstrated 25% sensitivity, 87.5% specificity, and 1.9% positive predictive value for intravascular catheter insertion. No intrathecal catheters were observed. For obstetric patients in the sitting position, the meniscus test does not improve diagnostic accuracy of aspiration for detecting intravascular multiorifice epidural catheter placement.
Author Mhyre, J.M
Greenfield, M.L.V.H
Polley, L.S
Servin, M.N
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Cites_doi 10.1111/j.1365-2044.1982.tb01153.x
10.1177/0310057X0703500303
10.1093/bja/79.3.297
10.1016/j.ijoa.2004.07.013
10.1111/j.1365-2044.1981.tb10329.x
10.1111/j.1365-2044.1990.tb14275.x
10.1046/j.1365-2044.1999.00894.x
10.1007/BF03010519
10.1213/01.ane.0000196687.88590.6b
10.1016/j.ijoa.2004.04.008
10.1111/j.1365-2044.1987.tb05181.x
10.1097/00000542-199808000-00022
10.1111/j.1365-2044.1981.tb08815.x
10.1016/j.ijoa.2006.03.007
10.1213/00000539-199610000-00013
10.1097/00000542-199010000-00004
10.1007/BF03019814
10.1097/00000542-200006000-00018
10.1213/00000539-199805000-00013
10.1097/00000542-199806000-00012
10.1213/01.ANE.0000120084.56136.15
10.1097/00000542-198705000-00017
10.1097/00000542-198102000-00016
10.1097/00000542-199601000-00011
10.1093/bja/64.2.183
10.1111/j.1471-0528.1990.tb02522.x
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Keywords Test dose
Meniscus test
Epidural: catheter, space
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References Guay (bib10) 2006; 102
Dickson, Moores, McClure (bib4) 1997; 79
D’Angelo, Berkebile, Gerancher (bib16) 1996; 84
Beilin, Bodian, Haddad, Leibowitz (bib11) 1996; 83
Leighton, Norris, DeSimone, Rosko, Gross (bib21) 1990; 73
Norris, Fogel, Dalman, Borrenpohl, Hoppe, Riley (bib13) 1998; 88
Morrison, Buchan (bib5) 1990; 64
Okell, Sprigge (bib18) 1987; 42
Toledano, Roizen, Foss (bib6) 1995; 80
Marx, Elstein, Schuss, Anyaegbunam, Fleischer (bib7) 1990; 97
Kenepp, Gutsche (bib20) 1981; 54
Colonna-Romano, Nagaraj (bib26) 1998; 86
Leighton, Norris, Sosis, Epstein, Chayen, Larijani (bib28) 1987; 66
Shah (bib1) 1982; 37
Evron, Sessler, Sadan, Boaz, Glezerman, Ezri (bib17) 2004; 99
Dain, Rolbin, Hew (bib27) 1987; 34
Bahar, Chanimov, Cohen (bib15) 2001; 48
Burnstein, Buckland, Pickett (bib12) 1999; 54
Shah (bib23) 1981; 36
Trojanowski, Murray (bib8) 1995; 85
Messih (bib24) 1981; 36
Nystrom, Blomberg, Buffington (bib25) 1998; 89
Gowrie-Mohan, Peck (bib3) 2006; 15
Bell, Leslie (bib9) 2007; 35
Pan, Bogard, Owen (bib14) 2004; 13
Gardner, Kinsella (bib2) 2005; 14
Reynolds, Speedy (bib19) 1990; 45
Leighton, Topkis, Gross (bib22) 2000; 92
Burnstein (10.1016/j.ijoa.2008.11.008_bib12) 1999; 54
D’Angelo (10.1016/j.ijoa.2008.11.008_bib16) 1996; 84
Leighton (10.1016/j.ijoa.2008.11.008_bib28) 1987; 66
Bell (10.1016/j.ijoa.2008.11.008_bib9) 2007; 35
Messih (10.1016/j.ijoa.2008.11.008_bib24) 1981; 36
Nystrom (10.1016/j.ijoa.2008.11.008_bib25) 1998; 89
Gowrie-Mohan (10.1016/j.ijoa.2008.11.008_bib3) 2006; 15
Reynolds (10.1016/j.ijoa.2008.11.008_bib19) 1990; 45
Trojanowski (10.1016/j.ijoa.2008.11.008_bib8) 1995; 85
Beilin (10.1016/j.ijoa.2008.11.008_bib11) 1996; 83
Gardner (10.1016/j.ijoa.2008.11.008_bib2) 2005; 14
Morrison (10.1016/j.ijoa.2008.11.008_bib5) 1990; 64
Norris (10.1016/j.ijoa.2008.11.008_bib13) 1998; 88
Kenepp (10.1016/j.ijoa.2008.11.008_bib20) 1981; 54
Leighton (10.1016/j.ijoa.2008.11.008_bib22) 2000; 92
Marx (10.1016/j.ijoa.2008.11.008_bib7) 1990; 97
Okell (10.1016/j.ijoa.2008.11.008_bib18) 1987; 42
Toledano (10.1016/j.ijoa.2008.11.008_bib6) 1995; 80
Colonna-Romano (10.1016/j.ijoa.2008.11.008_bib26) 1998; 86
Guay (10.1016/j.ijoa.2008.11.008_bib10) 2006; 102
Evron (10.1016/j.ijoa.2008.11.008_bib17) 2004; 99
Leighton (10.1016/j.ijoa.2008.11.008_bib21) 1990; 73
Shah (10.1016/j.ijoa.2008.11.008_bib1) 1982; 37
Dain (10.1016/j.ijoa.2008.11.008_bib27) 1987; 34
Shah (10.1016/j.ijoa.2008.11.008_bib23) 1981; 36
Dickson (10.1016/j.ijoa.2008.11.008_bib4) 1997; 79
Pan (10.1016/j.ijoa.2008.11.008_bib14) 2004; 13
Bahar (10.1016/j.ijoa.2008.11.008_bib15) 2001; 48
References_xml – volume: 85
  start-page: 531
  year: 1995
  end-page: 534
  ident: bib8
  article-title: A test to prevent subarachnoid and intravascular injections during epidural analgesia
  publication-title: S Afr Med J
  contributor:
    fullname: Murray
– volume: 73
  start-page: 610
  year: 1990
  end-page: 613
  ident: bib21
  article-title: The air test as a clinically useful indicator of intravenously placed epidural catheters
  publication-title: Anesthesiology
  contributor:
    fullname: Gross
– volume: 54
  start-page: 634
  year: 1999
  end-page: 640
  ident: bib12
  article-title: A survey of epidural analgesia for labour in the United Kingdom
  publication-title: Anaesthesia
  contributor:
    fullname: Pickett
– volume: 54
  start-page: 172
  year: 1981
  end-page: 173
  ident: bib20
  article-title: Inadvertent intravascular injections during lumbar epidural anesthesia
  publication-title: Anesthesiology
  contributor:
    fullname: Gutsche
– volume: 13
  start-page: 227
  year: 2004
  end-page: 233
  ident: bib14
  article-title: Incidence and characteristics of failures in obstetric neuraxial analgesia and anesthesia: a retrospective analysis of 19,259 deliveries
  publication-title: Int J Obstet Anesth
  contributor:
    fullname: Owen
– volume: 45
  start-page: 120
  year: 1990
  end-page: 123
  ident: bib19
  article-title: The subdural space: the third place to go astray
  publication-title: Anaesthesia
  contributor:
    fullname: Speedy
– volume: 88
  start-page: 1495
  year: 1998
  end-page: 1501
  ident: bib13
  article-title: Labor epidural analgesia without an intravascular “test dose”
  publication-title: Anesthesiology
  contributor:
    fullname: Riley
– volume: 64
  start-page: 183
  year: 1990
  end-page: 185
  ident: bib5
  article-title: Comparison of complications associated with single-holed and multi-holed extradural catheters
  publication-title: Br J Anaesth
  contributor:
    fullname: Buchan
– volume: 15
  start-page: 333
  year: 2006
  end-page: 334
  ident: bib3
  article-title: Epidural test dose
  publication-title: Int J Obstet Anesth
  contributor:
    fullname: Peck
– volume: 35
  start-page: 335
  year: 2007
  end-page: 341
  ident: bib9
  article-title: Detection of intravascular epidural catheter placement: a review
  publication-title: Anaesth Intensive Care
  contributor:
    fullname: Leslie
– volume: 86
  start-page: 985
  year: 1998
  end-page: 988
  ident: bib26
  article-title: Tests to evaluate intravenous placement of epidural catheters in laboring women: a prospective clinical study
  publication-title: Anesth Analg
  contributor:
    fullname: Nagaraj
– volume: 42
  start-page: 1110
  year: 1987
  end-page: 1113
  ident: bib18
  article-title: Unintentional dural puncture. A survey of recognition and management
  publication-title: Anaesthesia
  contributor:
    fullname: Sprigge
– volume: 92
  start-page: 1617
  year: 2000
  end-page: 1620
  ident: bib22
  article-title: Multiport epidural catheters: does the air test work?
  publication-title: Anesthesiology
  contributor:
    fullname: Gross
– volume: 48
  start-page: 48
  year: 2001
  end-page: 53
  ident: bib15
  article-title: Lateral recumbent head-down posture for epidural catheter insertion reduces intravascular injection
  publication-title: Can J Anesth
  contributor:
    fullname: Cohen
– volume: 84
  start-page: 88
  year: 1996
  end-page: 93
  ident: bib16
  article-title: Prospective examination of epidural catheter insertion
  publication-title: Anesthesiology
  contributor:
    fullname: Gerancher
– volume: 89
  start-page: 449
  year: 1998
  end-page: 455
  ident: bib25
  article-title: Transmural pressure of epidural veins in the thoracic and lumbar spine of pigs
  publication-title: Anesthesiology
  contributor:
    fullname: Buffington
– volume: 34
  start-page: 601
  year: 1987
  end-page: 605
  ident: bib27
  article-title: The epidural test dose in obstetrics: is it necessary?
  publication-title: Can J Anaesth
  contributor:
    fullname: Hew
– volume: 80
  start-page: 861
  year: 1995
  end-page: 863
  ident: bib6
  article-title: When is testing the test dose the wrong thing to do?
  publication-title: Anesth Analg
  contributor:
    fullname: Foss
– volume: 83
  start-page: 735
  year: 1996
  end-page: 741
  ident: bib11
  article-title: Practice patterns of anesthesiologists regarding situations in obstetric anesthesia where clinical management is controversial
  publication-title: Anesth Analg
  contributor:
    fullname: Leibowitz
– volume: 102
  start-page: 921
  year: 2006
  end-page: 929
  ident: bib10
  article-title: The epidural test dose: a review
  publication-title: Anesth Analg
  contributor:
    fullname: Guay
– volume: 66
  start-page: 688
  year: 1987
  end-page: 691
  ident: bib28
  article-title: Limitations of epinephrine as a marker of intravascular injection in laboring women
  publication-title: Anesthesiology
  contributor:
    fullname: Larijani
– volume: 79
  start-page: 297
  year: 1997
  end-page: 300
  ident: bib4
  article-title: Comparison of single, end-holed and multi-orifice extradural catheters when used for continuous infusion of local anaesthetic during labour
  publication-title: Br J Anaesth
  contributor:
    fullname: McClure
– volume: 36
  start-page: 627
  year: 1981
  end-page: 631
  ident: bib23
  article-title: Influence of cerebrospinal fluid on epidural pressure
  publication-title: Anaesthesia
  contributor:
    fullname: Shah
– volume: 36
  start-page: 775
  year: 1981
  end-page: 782
  ident: bib24
  article-title: Epidural space pressures during pregnancy
  publication-title: Anaesthesia
  contributor:
    fullname: Messih
– volume: 14
  start-page: 96
  year: 2005
  end-page: 103
  ident: bib2
  article-title: Obstetric epidural test doses: a survey of UK practice
  publication-title: Int J Obstet Anesth
  contributor:
    fullname: Kinsella
– volume: 97
  start-page: 517
  year: 1990
  end-page: 520
  ident: bib7
  article-title: Effects of epidural block with lignocaine and lignocaine-adrenaline on umbilical artery velocity wave ratios
  publication-title: Br J Obstet Gynaecol
  contributor:
    fullname: Fleischer
– volume: 99
  start-page: 245
  year: 2004
  end-page: 250
  ident: bib17
  article-title: Identification of the epidural space: loss of resistance with air, lidocaine, or the combination of air and lidocaine
  publication-title: Anesth Analg
  contributor:
    fullname: Ezri
– volume: 37
  start-page: 426
  year: 1982
  end-page: 427
  ident: bib1
  article-title: A test to show correct placement of epidural catheter
  publication-title: Anaesthesia
  contributor:
    fullname: Shah
– volume: 37
  start-page: 426
  year: 1982
  ident: 10.1016/j.ijoa.2008.11.008_bib1
  article-title: A test to show correct placement of epidural catheter
  publication-title: Anaesthesia
  doi: 10.1111/j.1365-2044.1982.tb01153.x
  contributor:
    fullname: Shah
– volume: 35
  start-page: 335
  year: 2007
  ident: 10.1016/j.ijoa.2008.11.008_bib9
  article-title: Detection of intravascular epidural catheter placement: a review
  publication-title: Anaesth Intensive Care
  doi: 10.1177/0310057X0703500303
  contributor:
    fullname: Bell
– volume: 79
  start-page: 297
  year: 1997
  ident: 10.1016/j.ijoa.2008.11.008_bib4
  article-title: Comparison of single, end-holed and multi-orifice extradural catheters when used for continuous infusion of local anaesthetic during labour
  publication-title: Br J Anaesth
  doi: 10.1093/bja/79.3.297
  contributor:
    fullname: Dickson
– volume: 14
  start-page: 96
  year: 2005
  ident: 10.1016/j.ijoa.2008.11.008_bib2
  article-title: Obstetric epidural test doses: a survey of UK practice
  publication-title: Int J Obstet Anesth
  doi: 10.1016/j.ijoa.2004.07.013
  contributor:
    fullname: Gardner
– volume: 36
  start-page: 627
  year: 1981
  ident: 10.1016/j.ijoa.2008.11.008_bib23
  article-title: Influence of cerebrospinal fluid on epidural pressure
  publication-title: Anaesthesia
  doi: 10.1111/j.1365-2044.1981.tb10329.x
  contributor:
    fullname: Shah
– volume: 45
  start-page: 120
  year: 1990
  ident: 10.1016/j.ijoa.2008.11.008_bib19
  article-title: The subdural space: the third place to go astray
  publication-title: Anaesthesia
  doi: 10.1111/j.1365-2044.1990.tb14275.x
  contributor:
    fullname: Reynolds
– volume: 54
  start-page: 634
  year: 1999
  ident: 10.1016/j.ijoa.2008.11.008_bib12
  article-title: A survey of epidural analgesia for labour in the United Kingdom
  publication-title: Anaesthesia
  doi: 10.1046/j.1365-2044.1999.00894.x
  contributor:
    fullname: Burnstein
– volume: 34
  start-page: 601
  year: 1987
  ident: 10.1016/j.ijoa.2008.11.008_bib27
  article-title: The epidural test dose in obstetrics: is it necessary?
  publication-title: Can J Anaesth
  doi: 10.1007/BF03010519
  contributor:
    fullname: Dain
– volume: 102
  start-page: 921
  year: 2006
  ident: 10.1016/j.ijoa.2008.11.008_bib10
  article-title: The epidural test dose: a review
  publication-title: Anesth Analg
  doi: 10.1213/01.ane.0000196687.88590.6b
  contributor:
    fullname: Guay
– volume: 13
  start-page: 227
  year: 2004
  ident: 10.1016/j.ijoa.2008.11.008_bib14
  article-title: Incidence and characteristics of failures in obstetric neuraxial analgesia and anesthesia: a retrospective analysis of 19,259 deliveries
  publication-title: Int J Obstet Anesth
  doi: 10.1016/j.ijoa.2004.04.008
  contributor:
    fullname: Pan
– volume: 42
  start-page: 1110
  year: 1987
  ident: 10.1016/j.ijoa.2008.11.008_bib18
  article-title: Unintentional dural puncture. A survey of recognition and management
  publication-title: Anaesthesia
  doi: 10.1111/j.1365-2044.1987.tb05181.x
  contributor:
    fullname: Okell
– volume: 89
  start-page: 449
  year: 1998
  ident: 10.1016/j.ijoa.2008.11.008_bib25
  article-title: Transmural pressure of epidural veins in the thoracic and lumbar spine of pigs
  publication-title: Anesthesiology
  doi: 10.1097/00000542-199808000-00022
  contributor:
    fullname: Nystrom
– volume: 36
  start-page: 775
  year: 1981
  ident: 10.1016/j.ijoa.2008.11.008_bib24
  article-title: Epidural space pressures during pregnancy
  publication-title: Anaesthesia
  doi: 10.1111/j.1365-2044.1981.tb08815.x
  contributor:
    fullname: Messih
– volume: 15
  start-page: 333
  year: 2006
  ident: 10.1016/j.ijoa.2008.11.008_bib3
  article-title: Epidural test dose
  publication-title: Int J Obstet Anesth
  doi: 10.1016/j.ijoa.2006.03.007
  contributor:
    fullname: Gowrie-Mohan
– volume: 83
  start-page: 735
  year: 1996
  ident: 10.1016/j.ijoa.2008.11.008_bib11
  article-title: Practice patterns of anesthesiologists regarding situations in obstetric anesthesia where clinical management is controversial
  publication-title: Anesth Analg
  doi: 10.1213/00000539-199610000-00013
  contributor:
    fullname: Beilin
– volume: 73
  start-page: 610
  year: 1990
  ident: 10.1016/j.ijoa.2008.11.008_bib21
  article-title: The air test as a clinically useful indicator of intravenously placed epidural catheters
  publication-title: Anesthesiology
  doi: 10.1097/00000542-199010000-00004
  contributor:
    fullname: Leighton
– volume: 85
  start-page: 531
  year: 1995
  ident: 10.1016/j.ijoa.2008.11.008_bib8
  article-title: A test to prevent subarachnoid and intravascular injections during epidural analgesia
  publication-title: S Afr Med J
  contributor:
    fullname: Trojanowski
– volume: 48
  start-page: 48
  year: 2001
  ident: 10.1016/j.ijoa.2008.11.008_bib15
  article-title: Lateral recumbent head-down posture for epidural catheter insertion reduces intravascular injection
  publication-title: Can J Anesth
  doi: 10.1007/BF03019814
  contributor:
    fullname: Bahar
– volume: 92
  start-page: 1617
  year: 2000
  ident: 10.1016/j.ijoa.2008.11.008_bib22
  article-title: Multiport epidural catheters: does the air test work?
  publication-title: Anesthesiology
  doi: 10.1097/00000542-200006000-00018
  contributor:
    fullname: Leighton
– volume: 86
  start-page: 985
  year: 1998
  ident: 10.1016/j.ijoa.2008.11.008_bib26
  article-title: Tests to evaluate intravenous placement of epidural catheters in laboring women: a prospective clinical study
  publication-title: Anesth Analg
  doi: 10.1213/00000539-199805000-00013
  contributor:
    fullname: Colonna-Romano
– volume: 88
  start-page: 1495
  year: 1998
  ident: 10.1016/j.ijoa.2008.11.008_bib13
  article-title: Labor epidural analgesia without an intravascular “test dose”
  publication-title: Anesthesiology
  doi: 10.1097/00000542-199806000-00012
  contributor:
    fullname: Norris
– volume: 99
  start-page: 245
  year: 2004
  ident: 10.1016/j.ijoa.2008.11.008_bib17
  article-title: Identification of the epidural space: loss of resistance with air, lidocaine, or the combination of air and lidocaine
  publication-title: Anesth Analg
  doi: 10.1213/01.ANE.0000120084.56136.15
  contributor:
    fullname: Evron
– volume: 66
  start-page: 688
  year: 1987
  ident: 10.1016/j.ijoa.2008.11.008_bib28
  article-title: Limitations of epinephrine as a marker of intravascular injection in laboring women
  publication-title: Anesthesiology
  doi: 10.1097/00000542-198705000-00017
  contributor:
    fullname: Leighton
– volume: 54
  start-page: 172
  year: 1981
  ident: 10.1016/j.ijoa.2008.11.008_bib20
  article-title: Inadvertent intravascular injections during lumbar epidural anesthesia
  publication-title: Anesthesiology
  doi: 10.1097/00000542-198102000-00016
  contributor:
    fullname: Kenepp
– volume: 84
  start-page: 88
  year: 1996
  ident: 10.1016/j.ijoa.2008.11.008_bib16
  article-title: Prospective examination of epidural catheter insertion
  publication-title: Anesthesiology
  doi: 10.1097/00000542-199601000-00011
  contributor:
    fullname: D’Angelo
– volume: 64
  start-page: 183
  year: 1990
  ident: 10.1016/j.ijoa.2008.11.008_bib5
  article-title: Comparison of complications associated with single-holed and multi-holed extradural catheters
  publication-title: Br J Anaesth
  doi: 10.1093/bja/64.2.183
  contributor:
    fullname: Morrison
– volume: 80
  start-page: 861
  year: 1995
  ident: 10.1016/j.ijoa.2008.11.008_bib6
  article-title: When is testing the test dose the wrong thing to do?
  publication-title: Anesth Analg
  contributor:
    fullname: Toledano
– volume: 97
  start-page: 517
  year: 1990
  ident: 10.1016/j.ijoa.2008.11.008_bib7
  article-title: Effects of epidural block with lignocaine and lignocaine-adrenaline on umbilical artery velocity wave ratios
  publication-title: Br J Obstet Gynaecol
  doi: 10.1111/j.1471-0528.1990.tb02522.x
  contributor:
    fullname: Marx
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Snippet Abstract Background The meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while...
The meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while physically...
BACKGROUNDThe meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while...
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SubjectTerms Adult
Analgesia, Epidural - instrumentation
Analgesia, Obstetrical - instrumentation
Anesthesia & Perioperative Care
Blood Vessels - injuries
Catheterization - adverse effects
Clinical Protocols
Cohort Studies
Epidural: catheter, space
Female
Humans
Meniscus test
Obstetrics and Gynecology
Pregnancy
Prospective Studies
Sensitivity and Specificity
Test dose
Treatment Outcome
Wounds, Penetrating - diagnosis
Wounds, Penetrating - prevention & control
Title An observational cohort study of the meniscus test to detect intravascular epidural catheters in pregnant women
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https://dx.doi.org/10.1016/j.ijoa.2008.11.008
https://www.ncbi.nlm.nih.gov/pubmed/19447601
https://search.proquest.com/docview/67406472
Volume 18
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