The characteristics of the two methods of epidural puncture needle:
May 23, 2022
① Direct entry method:
First of all, straight into the method of higher than the requirements of the posture, the need to cooperate, it is very likely to bend the waist, so that its spinous process gap as far as possible open. The puncture route needs to go through the triple ligaments of the supraspinal ligament, the interspinous ligament and the ligamentum flavum. Due to the large number of ligaments punctured, the ligamentum is dense connective tissue with few capillaries, so it is difficult to repair the injury and is prone to pain at the puncture site for a long period of time after surgery. But from the clinical point of view, direct puncture or receive many anesthesiologists favor.
(2) the side into the law:
However, the lateral approach method has relatively low requirements for position, even if the spine is straight, the puncture may be successful, and the lateral approach method does not need to go through the supraspinous ligament and the interspinous ligament, and its crossing phase is: skin -- superficial fascia -- deep fascia -- platyscapular aponeurosis -- sacrospinal muscle -- laminar space -- ligamentum flavum -- epidural space. It is clear that the lateral approach can reduce or avoid postoperative puncture site pain. In addition, from the body, the lateral puncture method has a high success rate. Although many hospitals still use the straight approach, more and more anesthesiologists are routinely using the lateral approach.
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