The patient needs multiple operations, do the needle points for spinal anesthesia need to be changed?

lumbar puncture 

The lumbar puncture kit includes the necessary equipment for performing a lumbar puncture: a lumbar puncture needle with a core, skin antiseptic solution, surgical drape, collection tube, and a manometer. The 22-gauge needle is preferred because the smaller puncture hole reduces the risk of CSF leakage. In general, babies use 1.5-inch (3.8 cm) needles, children use 2.5-inch (6.3 cm) needles, and adults use 3.5-inch (8.9 cm) needles.

Draw a line between the upper borders of the iliac crests on both sides, intersecting the midline passing through the L4 spinous process. Insert the needle in the space between L3 and L4 or L4 and L5, as these points are located below the terminal segment of the spinal cord. Physicians should look for landmarks before sterilizing the skin and injecting local anesthetic, as these operations have the potential to obscure the landmarks. Use a skin marker to mark the correct location.

If the needle is placed in the correct position, the needle should pass through the skin, subcutaneous tissue, supraspinous ligament, interspinous ligament between spinous processes, ligamentum flavum, and epidural space (including the internal vertebral venous plexus, dura mater, and arachnoid) in order. , enters the subarachnoid space and is located between the roots of the cauda equina. As the needle passes through the ligamentum flavum, the physician can feel a sense of breakthrough. At this time, the needle core should be pulled out 2 mm to observe whether there is cerebrospinal fluid outflow. If the puncture is unsuccessful and touches the bone, withdraw the puncture needle to the subcutaneous tissue, but do not withdraw from the skin, adjust the direction and insert the needle again. Once the needle enters the subarachnoid space, there is CSF outflow. If there is trauma during the puncture, the CSF may be slightly bloody. When the CSF is collected, the CSF should be clear and bloodless, unless there is subarachnoid hemorrhage. If the flow of CSF is poor, the needle may be rotated 90 degrees because the opening of the needle may be blocked by a nerve root.

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