What are the causes of rupture of the epidural during epidural block and how to deal with it

Epidural puncture is a blind probing puncture, so the puncturator should be familiar with the anatomical levels, insert the needle slowly, carefully experience the puncture sensation at different levels of the intervertebral ligament, and test the phenomenon of loss of resistance and negative pressure while inserting the needle, so as to avoid the total subarachnoid space block and spinal cord injury caused by the puncture of the dural. Anesthetized person is paralytic careless, beg fast but enter needle too fierce, sometimes error and

Rupture of the dural. The long bevel of the needle and the hard texture of the catheter will increase the possibility of puncturing the dura, which is sometimes difficult to detect in time. Patients with repeated epidural block, epidural space due to repeated trauma bleeding, drug chemical stimulation hard

The outer membrane gap makes its adhesion and narrowing, and even locked, easy to wear through the dural. Spinal deformity or pathological changes, huge abdominal tumor or ascites, spinal curve is not easy, puncture is difficult, repeated puncture, easy to Pierce the dural. The elderly ligament calcification, puncture force is too large, can cause dural rupture. The epidural space of children is narrower than that of adults. If children do not have basic anesthesia or insufficient drug dosage, they can cause epidural puncture by moving a little. Once the dural is punctured, other anesthesia methods should be used, such as puncture below the L2 space, surgical area in the lower abdomen, lower limb or anal or perineal area, instead of subarachnoid space block. Hope this answer is helpful

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