When performing neuraxial anesthesia, the nondominant hand is used to stabilize the needle. One method for stabilizing the needle is shown in this graphic, with the knuckle of the index finger held against the patient's back. The index finger and thumb of the nondominant hand should be used to hold the needle hub when removing the loss of resistance syringe during epidural anesthesia, and when connecting the syringe during spinal anesthesia.
Reproduced with permission from: Bernards CM, Hostetter LS. Epidural and spinal anesthesia. In: Clinical Anesthesia, 7th ed, Barash PG, Cullen BF, Stoelting RK, et al (Eds), Lippincott Williams & Wilkins, Philadelphia 2013. Copyright © 2013 Lippincott Williams & Wilkins.
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