How to choose various anesthesia methods

The selection of anesthesia methods varies, including general anesthesia, epidural nerve block anesthesia, lumbar anesthesia, local anesthesia and combined anesthesia, local anesthesia plus lumbar anesthesia, local anesthesia plus general anesthesia, etc.

The fundamental purpose of anesthesia is to enable the patient to complete the operation smoothly and quickly without pain. Doctors choose anesthesia according to their own experience and surgical methods, and all kinds of anesthesia have advantages and disadvantages.

(1) General anesthesia: At present, for the general surgical method of lumbar disc herniation has rarely taken this kind of anesthesia. However, in the microsurgical method of nucleus pulposus removal, general anesthesia should be used to keep the patient immobile.

(2) Epidural nerve block anesthesia: it can make the patient painless during the operation, but there is incomplete analgesia when pulling the nerve root. If the central type of disc herniation, the need for incision of the nucleus pulposus, it is not appropriate. Due to the high concentration of epidural anesthesia drugs into the subarachnoid space, will lead to the excessive amount of spinal anesthesia drugs, anesthesia accidents are easy to occur.

(3) Lumbar anesthesia: produces the effect of spinal anesthesia, not only the affected nerve anesthesia, the whole cauda equina nerve anesthesia.

Both types of anesthesia require accurate location of the nerve compression site before and during surgery. At the same time, in case of accidental injury of the nerve is not easy to be detected by the surgeon.

(4) Local anesthesia: When the operation is performed under local infiltration anesthesia, the patient is very painful when the nerve root is pulled. The advantages of this method are that it can correctly locate the involved nerve root according to the intraoperative observation and the patient's awake sensory condition, and can find the protrusion of nucleus pulposus missed by clinical and X-ray examination, so as to avoid accidentally injuring the nerve root.

Due to the poor analgesia of local anesthesia of pulling nerve roots, procaine 50mg can be injected into subarachnoid space as lumbar anesthesia or ketamine 50mg can be injected intravenously into general anesthesia to play a brief and complete analgesic effect when the nucleus pulposus is removed after the location and extent of the lesion is determined. During this time, the nerve root was retracted and the nucleus pulposus was removed.

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