What are the reasons that break dura when epidural block, how to deal with

Epidural puncture is a blind exploration puncture. Therefore, the puncture user should be familiar with the anatomical level, slowly insert the needle during puncture, carefully understand the puncture sensation of different levels of intervertebral ligament, and test the disappearance of resistance and negative pressure while inserting the needle, so as to avoid total subarachnoid block and spinal cord injury caused by puncture of the spinal dura. The anesthetized person is careless, seeks fast and enters the needle too fiercely, sometimes the mistake but

Rupture of the dura. Needle bevel is too long, conduit texture is very hard, can increase the POSSIBILITY of piercing dURAL, this KIND OF piercing sometimes is not easy to discover in time. The epidural space is hard due to repeated trauma bleeding and drug chemical stimulation

The outer space of the membrane makes it adhesion and narrow, or even atresia, easy to penetrate the dura. Spinal deformity or lesion, huge abdominal tumor or ascites, spinal curvature is not easy, puncture is difficult, repeated puncture, easy to Pierce the dura. Calcification of ligaments and excessive force during puncture in the elderly may cause dural perforation. The epidural space in children is narrower than that in adults. If there is no basic anesthesia or insufficient drug dosage in children, a little movement during puncture can cause dural puncture. Once the dura has been penetrated, other anesthesia methods should be used, such as puncture below the L2 space, the surgical area of the lower abdomen, lower limbs, or the anal and perineal area, changed to subarachnoid block. Hope you found this answer helpful

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