Precautions for epidural puncture needles

1. Understand the condition in detail, explain the method, purpose, effect and precautions to the patient before the block, so that the patient has an understanding of the operation, gain the trust of the patient, and eliminate the fear.

2. Prepare first aid supplies, such as ventilator, ECG monitor, tracheal intubation, suction device and various rescue medicines.

3. Maintain the patient's corresponding operating position, soothe the patient, and eliminate the patient's nervousness.

4. Complete the operation equipment, and check whether the operation equipment is missing or damaged, and check the medicine before the operation.

5. The entire operation process follows the principle of asepticity, and the operation is carried out in strict accordance with the operating guidelines. Conditions permitting, the operation can be performed under C-arm fluoroscopy or B-mode ultrasound guidance.

6. After the operation, the patient should go to supine on the pillow and change to a semi-recumbent position after 6 or 12 hours.

7. If the patient has nausea or vomiting, the head should be tilted to one side to prevent the vomit from being inhaled into the trachea.

8. Observe the changes in mind, T, P, R, BP. Blood pressure should be measured every hour. After 4 times of stability, change to once every 4 hours.

9. After the anesthesia disappears, check whether the temperature and touch of the lower limbs are normal, and whether the motor function is restored. If the lower limbs are unable to move, the possibility of the epidural hematoma compressing the spinal cord should be considered, and it should be dealt with in time.

10. If you have headache or dizziness, observe the cause.

11. Pay attention to observe whether there is infection in the epidural space. If there is an infection, it should be treated in time, using antibacterial drugs and bacterial culture.

Considering the overall, long-term, and safety of the patient, epidural anesthetics should be based on local anesthetics, with a small amount of steroids and vitamin B group, to prevent the injection of too many kinds of drugs.

Don't forget that the structure of the epidural space is complicated. Misuse of some drugs that shouldn't be used can cause neurotoxicity, demyelination, arteritis, venous thrombosis, hyperplasia and adhesion changes.

Complications caused by injecting glucocorticoids into the epidural space are mainly caused by infections caused by steroids suppressing the immune state, and irritating chemicals (antibacterial agents, excipients) contained in steroid preparations can cause aseptic and inflammatory complications .

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