I’ve read some interesting articles on this subject. I thought I would take a poll.

So, you are called to the labor floor to place an epidural. On exam the patient has a large tramp stamp covering her lumbar spine. For the sake of this discussion, let’s say it is a colorful dragon, covering the midline from L2-S1. Fortunately the dragon’s eye is right at the L3-4 interspace. What do you do?

Current litrature citations welcome.