الفهرس 
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Abstract
This study demonstrated the usage of extra tools in epidural technique for improving epidural block, correctly identifying the location of the space not only determines the success or failure of the epidural space procedure but may also influence the onset of action and rate of absorption of the drugs.
The failure rate may lie between 30–50%.Failure to access the epidural space may be secondary to challenging anatomy or the experience and skill of the anesthesiologist
Inadequate analgesia or anesthesia experienced with catheters in the epidural space may have a variety of causes including catheter migration out of the ‘posterior’ epidural space, space occupying masses, placing the epidural catheter at an inappropriate level based on unreliable surface landmarks and maldistribution of drugs delivered into the epidural space.
This study was carried in Ain Shams University Hospital and Ain Shams University Specialized Hospital on 60 patients scheduled for elective lower abdominal surgery (eg. Inguinal hernia repair, varicocele, total abdominal hysterectomy), lasting 1-2 hours were selected.