Pov tseg Epidural Needle Tips?

Epidural anesthesia tuaj yeem muab faib ua ib qho tshuaj loog epidural thiab kev siv tshuaj loog tas li, cov menyuam yaus thiab cov neeg laus tuaj yeem siv. Nws yog qhov tsim nyog rau kev phais qhov quav thiab kev phais qhov quav nrog lub sijhawm ua haujlwm ntev, xws li anoplasty, thiab lwm yam.

Txoj kev ua haujlwm: Tus neeg mob coj txoj haujlwm lateral decubitus, lub duav rov qab mus rau sab nraub qaum, ob lub hauv caug mus rau phab ntsa plab. Nyob rau nruab nrab ntawm cov txheej txheem sab sauv thiab sab qis ntawm qhov chaw intervertebral xaiv, ib qho piculus yog tsim, thiab tom qab ntawd cov koob yog vertically nkag mus, thiab cov tshuaj me me raug txhaj thaum nkag mus rau hauv rab koob, kom txog thaum ligamentum flavum (tsis kam nce) tawm ntawm rab koob, thiab ib rab koob me ntsis tuab yog xaiv thiab muab tso rau ntawm lub piculus rau hauv ligamentum flavum thiab tawm. Lub epidural puncture koob ntawm rab diav taub hau yog ntxig rau ntawm lub qhov muag ntawm rab koob. Thaum lub ligamentum flavum tau mus txog, qhov kev tiv thaiv nce ntxiv, thiab lub koob tseem ceeb raug tshem tawm thiab ib lub khob me me txuas nrog. Sau nrog me me ntawm isotonic saline. Tom qab ntawd, sim qhov kev tawm tsam thaum maj mam nkag mus rau hauv rab koob hauv kev coj ntawm kev sib hloov. Thaum lub ligamentum flavum tau nkag mus, kev tiv thaiv tam sim ntawd ploj mus thiab me ntsis ntsev tau nqus tau, qhia tias qhov ntxeev tau nkag mus rau hauv qhov chaw epidural. Cov iav raj raug tshem tawm, lub koob txhaj tshuaj txuas nrog, thiab cov kua cerebrospinal thiab ntshav tau nqus rov qab. Nws tau raug lees paub tias cov kua dej cerebrospinal nyob hauv qhov chaw epidural, thiab cov hlab ntsha thiab qhov chaw subarachnoid tsis tau mus rau hauv. Yog tias ib qho epidural raug xaiv, cov tshuaj tuaj yeem txhaj. Thaum xaiv cov tshuaj loog epidural tas mus li, cov yas catheter tau muab tso rau hauv lub koob, qhov ntev yog 3cm dhau ntawm lub taub hau raws li qhov degree, lub koob txhaj tshuaj tau muab tshem tawm, cov yas catheter tau khaws cia rau kev kho, thiab cov tshuaj tau muab los ntawm catheter. nyob rau hauv txawv sij hawm raws li qhov xav tau ntawm kev ua haujlwm. Tom qab cov txheej txheem, lub catheter raug tshem tawm. Feem ntau siv tshuaj loog yog: 2 feem pua ​​​​lidocaine, 0.5 feem pua ​​​​bupivacaine sib npaug, ntxiv ib qho me me ntawm adrenaline.