Ki jan yo jije ke zegwi a te antre nan espas epidural la soti nan nivo a disseksyon nan po a nan espas ki la subarachnoid?

Epidural anesthesia is epidural nerve block anesthesia. The operation method is as follows: (1) In the lateral position, hold the knee joint with both hands, and press the lower jaw against the chest to form a flexion. (2) According to the requirements, select the intervertebral space between the 10th thoracic vertebra and the 4th lumbar vertebra, 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 anesthesia is injected into the subdural space. Commonly used anesthesia is 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 given successively as required. The whole process of anesthesia should pay close attention to the patient's response and changes in the level of anesthesia. (5) If continuous epidural anesthesia is required, first take a ureteral catheter corresponding to the size of the spoon-shaped needle, test whether it is unobstructed in advance, and measure the length and size. Place the bevel of the spoon-shaped needle upward (or downward, as required), and after the ureteral catheter is inserted into the epidural space from the needle cavity, pull out the needle while slowly advancing the catheter to the epidural space. It can be left in the epidural space for 3 to 5 cm, not too long. When pulling out the spoon-shaped needle, do not take the catheter out of the lumen, and try to inject a small amount of anesthesia from the catheter, about 2 mL, if there is no resistance, no local bulge, and no liquid overflow, it proves that the catheter is still in the external lumen. Finally, the catheter left outside the body is fixed straight on the back with adhesive tape to prevent prolapse and bending into an angle, so as to ensure that the catheter is unobstructed and given during the operation.

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