I read the article by Dr Pearce et al with interest.I like to make a comment on the technique of epidural needle insertion.It is taught that the epidural needle should be inserted with the stillet in till the interspinous  ligament is penetrated.Till this time chances of needle gets blocked is higher because of subcutaneous fatty tissues.After that because of pressure of saline or air chances of getting needle blocked is less.This simple technique will reduce the dural tap because of needle blockage.

Dr M Haldar

Queen's Hospital

Burton-on-Trent