Internal jugular vein compression to assess the correct placement of an epidural catheter in postpartum women.

We investigated whether the increase in epidural pressure produced by jugular compression could be used as a test for correct placement of epidural catheters in 20 postpartum women who had good epidural analgesia during labour. We measured the epidural pressure by using the epidural catheter as a manometer, and measured the rise in the meniscus in response to jugular vein compression whilst the epidural catheter was still in the epidural space. The catheter was then withdrawn until the tip lay just outside the epidural space and the response to jugular vein compression reassessed. In all subjects, jugular vein compression produced a rise in the meniscus only whilst the catheter tip lay in the epidural space. Jugular compression is a useful test for confirming the correct placement of the epidural catheter.