Dogliotti's principle

Dogliotti's principle is a principle in epidural anaesthesia first described by Professor Achille Mario Dogliotti in 1933.^[1] 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 epidural space due to the change in pressure.^[2]^[3] 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 present, 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.^[3]^[4]^[5]

References

↑ Dogliotti, AM (1933). "Research and clinical observations on spinal anesthesia: with special reference to the peridural technique" (PDF). Anesthesia & Analgesia. 12 (2): 59–65. doi:10.1213/00000539-193301000-00014.
↑ Iklé A (July 1950). "Preliminary report of new technique for epidural anaesthesia.". British Journal of Anaesthesia. 22 (3): 150–5. doi:10.1093/bja/22.3.150. PMID 15426701.
1 2 Wilson MJA (2007). "Epidural endeavour and the pressure principle.". Anaesthesia. 62 (4): 319–324. doi:10.1111/j.1365-2044.2007.05063.x. PMID 17381564.
↑ Naulty JS, Ostheimer GW, Datta S, Knapp R, Weiss JB (November 1982). "Incidence of venous air embolism during epidural catheter insertion". Anesthesiology. 57 (5): 410–2. doi:10.1097/00000542-198211000-00010. PMID 7137620.
↑ Simopoulos T, Peeters-Asdourian C (June 2001). "Pneumocephalus after cervical epidural steroid injection". Anesth. Analg. 92 (6): 1576–7. doi:10.1097/00000539-200106000-00045. PMID 11375849.

Anesthesia (outline)

Types	General Sedation Twilight anesthesia Local Topical Intercostal nerve block Neuraxial blockade Spinal Epidural Dental Inferior alveolar nerve

Techniques	Airway management Anesthesia provision in the US Arterial catheter Bronchoscopy Capnography Dogliotti's principle Drug-induced amnesia Intraoperative neurophysiological monitoring Nerve block Penthrox inhaler Tracheal intubation

Scientific Principles	Blood–gas partition coefficient Concentration effect Fink effect Minimum alveolar concentration Second gas effect

Measurements	ASA physical status classification system Baricity Bispectral index Direct Fick method Entropy monitoring Fick principle Goldman index Guedel's classification Mallampati score Neuromuscular monitoring Thyromental distance

Instruments	Anaesthetic machine Anesthesia cart Boyle's machine Gas cylinder Laryngeal mask airway Laryngeal tube Medical monitor Odom's indicator Relative analgesia machine Vaporiser Double-lumen endotracheal tube Endobronchial blocker

Complications	Emergence delirium Allergic reactions Anesthesia awareness Local anesthetic toxicity Malignant hyperthermia Perioperative mortality Postanesthetic shivering Postoperative nausea and vomiting Postoperative residual curarization

Fields of study	Cardiothoracic Geriatric Oral sedation dentistry

Professions	Anesthesiologist Anesthesiologist assistant Nurse anesthetist Operating Department Practitioners Certified Anesthesia Technician Certified Anesthesia Technologist Anaesthetic technician

History	A.C.E. mixture Helsinki Declaration for Patient Safety in Anaesthesiology History of general anesthesia History of neuraxial anesthesia History of tracheal intubation

Organizations	American Association of Nurse Anesthetists American Society of Anesthesia Technologists & Technicians American Society of Anesthesiologists Anaesthesia Trauma and Critical Care Association of Anaesthetists of Great Britain and Ireland Association of Veterinary Anaesthetists Australian and New Zealand College of Anaesthetists Australian Society of Anaesthetists International Anesthesia Research Society

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Dogliotti's principle

See also

References