Dogliotti's principle
Encyclopedia
Dogliotti's principle is a principle in epidural anaesthesia first described by Professor Achille Mario Dogliotti in 1933. It is a method for the identification of the epidural space
, a potential space
. As a needle is advanced through the ligamentum flavum, to the epidural space
, with constant pressure applied to the piston of a syringe, loss of resistance occurs once the needle enters the subdural space due to the change in pressure. The identification of this space, allows subsequent administration of epidural anaesthesia, a technique used primarily for analgesia during childbirth
.
This technique remains in use at , and is commonly referred to the loss of resistance to saline technique (LORS) or its variation, the loss of resistance to air technique (LORA). These use, respectively, saline or air to identify the epidural space. The LORS technique is generally favoured due to the increased complication risk with the LORA technique such as pneumocephalus
or air embolism
.
Epidural space
In the spine, the epidural space is the outermost part of the spinal canal. It is the space within the canal lying outside the dura mater...
, a potential space
Potential space
In anatomy, potential space refers to a space or cavity that can exist because two adjacent features that are not tightly adjoined, but does not appear during normal functioning.-Examples:* subdural space* vagina* pericardial cavity...
. As a needle is advanced through the ligamentum flavum, to the epidural space
Epidural space
In the spine, the epidural space is the outermost part of the spinal canal. It is the space within the canal lying outside the dura mater...
, with constant pressure applied to the piston of a syringe, loss of resistance occurs once the needle enters the subdural space due to the change in pressure. The identification of this space, allows subsequent administration of epidural anaesthesia, a technique used primarily for analgesia during childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
.
This technique remains in use at , and is commonly referred to the loss of resistance to saline technique (LORS) or its variation, the loss of resistance to air technique (LORA). These use, respectively, saline or air to identify the epidural space. The LORS technique is generally favoured due to the increased complication risk with the LORA technique such as pneumocephalus
Pneumocephalus
Pneumocephalus is the presence of air or gas within the cranial cavity. It is usually associated with disruption of the skull: after head and facial trauma, tumors of the skull base, after neurosurgery or otorhinolaryngology, and rarely, spontaneously...
or air embolism
Air embolism
An air embolism, or more generally gas embolism, is a pathological condition caused by gas bubbles in a vascular system. The most common context is a human body, in which case it refers to gas bubbles in the bloodstream...
.