Kif tittratta l-labra tat-titqib epidurali li tippenetra l-ispazju epidurali u tilħaq l-ispazju subarachnoid
Mar 31, 2022
Il-metodu tat-tħaddim huwa kif ġej:
(1) Mimdud fuq il-ġenb, għann il-ġog ta 'l-irkoppa biż-żewġ idejn, u agħfas ix-xedaq t'isfel kontra s-sider f'forma mgħawġa.
(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) Jekk tkun meħtieġa anestesija epidurali kontinwa, l-ewwel ħu kateter ureterali li jikkorrispondi mad-daqs tal-labra forma ta' mgħarfa-, ittestja jekk hijiex mhux ostakolata bil-quddiem, u kejjel it-tul u d-daqs. Poġġi ċ-ċanfrin tal-labra b'forma ta' mgħarfa-'l fuq (jew 'l isfel, kif meħtieġ), u wara li l-kateter ureterali jiddaħħal fl-ispazju epidurali mill-kavità tal-labra, iġbed il-labra 'l barra waqt li tavvanza bil-mod il-kateter għall-epidurali spazju. Jista 'jitħalla fl-ispazju epidurali għal 3 sa 5 ċm, mhux twil wisq. Meta tiġbed il-labra b'forma ta' kuċċarina-, tieħux il-kateter barra mill-lumen, u tipprova tinjetta ammont żgħir ta 'anestesija mill-kateter, madwar 2 mL, jekk ma jkunx hemm reżistenza, l-ebda nefħa lokali, u l-ebda overflow likwidu, jipprova li l-kateter għadu fil-lumen estern. Fl-aħħarnett, il-kateter li jitħalla barra l-ġisem huwa ffissat dritta fuq id-dahar b'tejp li jwaħħal biex jipprevjeni prolapse u liwi f'angolu, sabiex jiġi żgurat li l-kateter ma jkunx ostakolat u jingħata waqt l-operazzjoni.
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