This prospective observational study aims to evaluate the impact of epidural catheter placement techniques - loss of resistance (LOR) and hanging drop (HD) - on first-attempt success rates and procedural complications among anesthesia residents. Residents with at least two years of training will perform epidural catheterization under supervision for patients scheduled for elective surgery requiring perioperative epidural analgesia. An independent observer will record procedural details, complications, and postoperative pain scores. The study will enroll 440 patients aged 18-80 with ASA I-III classification.
Age 18-80 years
ASA physical status I, II, or III
Scheduled for elective surgery requiring perioperative epidural analgesia or anesthesia (lumbar or thoracic approach)
Epidural catheter to be placed by a resident with ≥ 2 years of anesthesia training
Spinal deformity (scoliosis, kyphosis, or prior spinal surgery at the target level)
Coagulopathy or anticoagulant therapy precluding neuraxial blockade
Active infection at the insertion site or systemic infection
Pre-existing neurological disease affecting the spinal cord or nerve roots