What are the preoperative preparation and operation steps for lumbar puncture?

Preoperative preparation: ① Equipment preparation: lumbar puncture bag, gloves, closed pressure gauge or glass pressure measuring tube, treatment disc, local anesthetics. ② Preoperative conversation and signed informed consent. ③ Those who are anesthetized with procaine need to do a skin test first. Operation steps: ① The patient is lying on the side, the head is bent forward, the back is perpendicular to the bed surface, and the knees are tucked with both hands to bend the knee joint to the chest as much as possible. ② Generally, the midpoint of the line connecting the double posterior superior iliac spines, that is, the 3rd to 4th lumbar intervertebral space, is selected as the puncture point, and the lumbar intervertebral space can be moved up and down if necessary. ③ Routinely disinfect the skin, wear sterile gloves, spread sterile towel, and check the instruments in the puncture bag. ④Take 2% procaine or lidocaine for local anesthesia. ⑤ The surgeon's left thumb presses the depression of the interspinous skin, and the right hand holds the puncture juice at the puncture point and pierces the subcutaneous skin, making the needle perpendicular to the dorsal plane or slightly inclined to the head and slowly piercing 4 to 6 cm. When the resistance of the needle tip suddenly decreases, it is indicated that the needle tip has passed through the dura, and then the needle is pushed forward. ⑥ Pull out the needle core, and the cerebrospinal fluid can be seen flowing out, and the specimen is collected for inspection. ⑦ When measuring the pressure, connect the pressure measuring tube (table), let the patient's legs straighten slowly, and read the pressure result. ⑧ If you need to inject medicine, first release a little cerebrospinal fluid, and then inject the medicine. ⑨ Insert the needle core, pull out the puncture needle, disinfect locally, and cover with gauze. Postoperatively, the patient was placed on the pillow for 4 to 6 hours.

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