Epidural Anesthesia, Epidural Nerve Block Anesthesia Needle Operation Method

(1) Pw rau sab, khawm lub hauv caug sib koom tes nrog ob txhais tes, thiab nias lub puab tsaig qis rau ntawm lub hauv siab nyob rau hauv ib tug flexed zoo.

(2) According to the requirements of the operation, select the intervertebral space between the 10th thoracic vertebra and the 4th lumbar vertebrae, first perform local anesthesia, and puncture with a spoon-shaped puncture needle. There are two puncture methods: ① pierce into the epidural space perpendicular to the spine, which is called straight puncture; ② pierce obliquely from the paravertebral side, called lateral puncture.

(3) When puncturing, the level passed is mainly judged according to the change of resistance. When the ligamentum flavum is encountered, the resistance increases and it feels tenacious. At this time, take out the needle core, connect the syringe with a small amount of air (or normal saline), and continue to insert the needle carefully. "Empty feeling", use the negative pressure of the epidural cavity to suck the air in the syringe into the cavity, and observe the change of the liquid level at the head of the syringe. If it fluctuates with the change of the negative pressure, it means that it has entered the hard ridge. extramembranous space. If there is no negative pressure and other phenomena, continue to insert the needle. If cerebrospinal fluid is found, it means that it has passed through the epidural space and entered the subarachnoid space, and the puncture fails and should be abandoned.

(4) It has been proved that in the epidural space, the anesthetics are injected in stages. Commonly used anesthetics are 2 percent lidocaine (also known as xylocaine) or 2 percent dicaine, plus 0.1 percent epinephrine 0.1 0.2mL. Generally, the single dose of lidocaine for adults should not exceed 500 mg, and the single dose of dicaine should not exceed 60 mg. Continuous epidural anesthesia can be administered in divided doses according to surgical requirements. The whole process of anesthesia should pay close attention to the patient's response and changes in the level of anesthesia.

(5) Yog tias yuav tsum tau txhaj tshuaj loog epidural tas li, ua ntej siv lub ureteral catheter sib haum rau qhov loj ntawm rab diav -zoo li tus koob, sim seb nws puas tsis muaj kev cuam tshuam ua ntej, thiab ntsuas qhov ntev thiab qhov loj me. Muab tus diav ntawm rab diav -zoo li rab koob upward (los yog downward, nyob ntawm seb yuav tsum tau phais), thiab ntxig lub ureteral catheter mus rau hauv lub epidural qhov chaw ntawm lub koob kab noj hniav. Rub tawm rab koob thaum maj mam nce lub catheter mus rau qhov chaw epidural. Lub catheter tuaj yeem tso rau hauv qhov chaw epidural rau 3 mus rau 5 cm, tsis ntev. Tsis txhob nqa lub catheter tawm ntawm lub lumen thaum rub tawm rab diav - zoo li tus koob, thiab sim txhaj tshuaj loog me me txog 2 mL ntawm lub catheter. Thaum kawg, lub catheter sab laug sab nraum lub cev tau tsau ncaj nraim rau sab nraub qaum nrog daim kab xev kom tiv thaiv prolapse thiab khoov rau hauv lub kaum sab xis, thiaj li ua kom lub patency ntawm lub catheter thiab intraoperative tswj.

Yog tias koj muaj lus nug, thov hu rau peb. Peb lub tuam txhab tuaj yeem tsim ntau yam koob txhaj tshuaj, koob tshuaj kho mob, koob txhaj tshuaj, koob tshuaj hypodermic, koob txhaj tshuaj, koob tshuaj tiv thaiv kab mob, koob txhaj tshuaj, koob txhaj tshuaj, koob tshuaj tua tsiaj, koob xaum koob, koob ovum khaws koob, koob txhaj tshuaj, thiab lwm yam Yog tias koj xav tau kev kho. koob cov khoom, thov hu rau peb. Peb tos ntsoov rau koj qhov kev nug! Qhov zoo ntawm cov khoom tsim nyob rau hauv peb lub Hoobkas yuav txaus siab rau koj!

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