Operation specification for combined spinal-epidural anesthesia

Spinal anesthesia-epidural combined block operation specification 1. Patient position Same spinal anesthesia

2. Puncture point L2-3 or L3-4.

3. Puncture method

Aseptic operation requires the same spinal anesthesia or epidural block needle. After the epidural puncture is successful, use the epidural puncture needle as a guide to insert a 25G lumbar puncture needle into the needle, pass the epidural puncture needle port, puncture the arachnoid membrane, and withdraw the needle core, and see the cerebrospinal fluid flowing out of the needle. Randomly inject 2-3ml of local anesthetic for spinal anesthesia, withdraw the lumbar puncture needle, insert the epidural catheter (through the needle port 3cm) through the epidural puncture needle, withdraw the epidural puncture needle, cover the puncture point with sterile gauze, and fix the catheter . After helping the patient to turn over and lie on their back, measure the blocking plane of spinal anesthesia. Inject 3-5ml of local anesthetic through the epidural catheter. After 5 minutes, there is no sign of excessive block level, and the operation can be started. During the operation, as needed, an appropriate amount of local anesthetic was injected through the epidural catheter to maintain anesthesia.

4. After light or heavy specific gravity local anesthetics are injected into the subarachnoid space, it will take some time to perform epidural operations, which will inevitably cause one side of the limb to be significantly blocked and the other side to be worse and affect the overall blocking effect. Therefore, it is often advocated to use isometric local anesthetics for spinal anesthesia during combined blockade.

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