The difference between epidural anesthesia needle and lumbar epidural combination

Even epidural is to Pierce the ligamentum flavum to reach the epidural space, local anesthetic injection into the epidural space to block nerve roots, theoretically from the cervical vertebrae to the sacral vertebrae can be hit, but now it is rare to see cervical vertebrae. Combined spinal and epidural anesthesia is a combination of lumbar anesthesia (subarachnoid anesthesia) and epidural anesthesia. The space of lumbar anesthesia is generally L2,3 or L3,4 can not be high, otherwise it will be full spinal anesthesia, because lumbar anesthesia is the drug directly injected into the subarachnoid space, block the spinal cord, the plane is high leading to central anesthesia is quite dangerous, so the amount of drug, lumbar anesthesia is much less than epidural. During the combination of lumbar and epidural anesthesia, the drug is first injected into the subarachnoid space through the lumbar anesthesia needle, and then the lumbar anesthesia needle is pulled out, and then a very thin tube is placed into the epidural space through the epidural puncture needle, so that the drug can be continuously administered into the epidural space, which is used to assist the anesthetic effect of the lumbar anesthesia.

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