Epidural needle anesthesia skills?

Epidural anesthesia is divided into single epidural anesthesia and continuous epidural anesthesia, both children and adults can use. It is suitable for rectal surgery and anal surgery with a long operation time, such as anoplasty.

Operation method: The patient is placed on his side, his back is arched back, and his knees are close to the abdominal wall. At the midpoint of the upper and lower spinous processes of the selected intervertebral space, make a dermatome, then insert the needle vertically, and inject a small amount of medicine as the needle is inserted, until the ligamentum flavum (increased resistance) exits the needle, choose a slightly thicker needle, from the skin Pierce the mound into the ligamentum flavum and exit, pierce the spoon-head epidural puncture needle along the eye of the needle. When it reaches the ligamentum flavum, the resistance increases significantly. At this time, the needle core is withdrawn and a small glass tube is connected with a small amount of isotonic saline. , And then test the resistance while slowly inserting the needle in the direction of rotation. When penetrating the ligamentum flavum, the resistance suddenly disappeared and a little saline was inhaled, indicating that the needle tip had entered the epidural space. Remove the glass tube, connect the syringe, suck back without cerebrospinal fluid and blood, and confirm that it is in the epidural space without mistakenly entering the blood vessel and subarachnoid space. If you choose a single epidural anesthesia, you can inject medicine. When choosing continuous epidural anesthesia, insert a plastic catheter into the needle with a length of 3 cm beyond the tip of the needle, withdraw the puncture needle, and place the plastic catheter for fixation. According to the needs of the operation, the drug is administered in divided doses through the catheter. After the operation, remove the catheter. Commonly used anesthetics are: 2% lidocaine, 0.5% bupivacaine, etc., plus a small amount of epinephrine.

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