What causes the pain in the area where the anesthetic is injected after a caesarean section? How to cure it?

Lumbar pain and discomfort after epidural anesthesia is a common complication after lumbar epidural anesthesia. Reports of its incidence vary, and the reason may be that the supraspinous ligament, interspinous ligament and ligamentum flavum are damaged by puncture .In addition, when the epidural catheter is placed in the epidural space, the nerve root and blood vessels are damaged, resulting in the release of pain-causing substances such as K+, H+, and serotonin at the trauma site, which can also cause pain. When performing epidural anesthesia puncture , The puncture needle needs to pass through the dense connective tissues such as the supraspinous ligament, the interspinous ligament and the ligamentum flavum. When the needle is inserted in parallel, the resistance is small, the sense of hierarchy is not obvious during the needle insertion process, and the feeling of failure is not obvious when the ligamentum flavum is punctured. When the needle is inserted vertically, the resistance is large, the layering is obvious during the needle insertion, and the feeling of falling is also obvious when the ligamentum flavum is punctured. It is inferred that when the profile of the needle tip is parallel to the longitudinal axis of the spine, the fracture damage of the fibrous tissue is small. On the contrary, When the needle is inserted vertically, more fibrous tissue is cut off the muscle ligament, and the rupture damage is large, because the blood supply of the supraspinous ligament, the interspinous ligament and the ligamentum flavum is low. The fibrous tissue of the damaged part is not conducive to repair. Aseptic inflammation may occur in the injured ligament. The supraspinous ligament, interspinous ligament and ligamentum flavum are rich in nerve fibers. Noxious stimulation activates the release of pain-causing substances from nerve fiber endings, resulting in the occurrence of pain and the increase in pain degree. Topical application of dexamethasone can inhibit the conduction of unmyelinated C-nerve fibers, inhibit inflammation and edema, and directly protect the mucosa. Epidural Dexamethasone in the cavity may exert its analgesic effect by inhibiting the activity of oxidase and the synthesis of prostaglandins at the wound site, inhibiting the activation of injured tissue and the release of inflammatory mediators, inhibiting nerve conduction of spinal nerve roots and direct protective effect of mucosa. As mentioned above, during epidural puncture, the needle tip section is parallel to the axis of the spine, which can reduce the damage to the muscles and ligaments, and can reduce the secondary reaction of the injury site. Meanwhile, the application of dexamethasone in the epidural space can reduce And the treatment of reducing back pain after lumbar epidural anesthesia: Diet adjustment: The diet of patients with low back pain is generally not much different from that of ordinary people. However, it is necessary to avoid excessive consumption of raw, cold and damp food, even in summer, it is not advisable to drink too much Frozen drinks. For cold and slippery fruits, such as watermelon, it is not advisable to eat too much at one time. For persistent chronic low back pain, you can always take some Chinese patent medicines that strengthen the kidney and strengthen the waist, such as Liuwei Dihuang Pill, Shenqi Pill, Shiquan Dabu Pills, etc., can be appropriately selected according to the constitution and condition. 3. Rehabilitation therapy: massage,

(1) Palm pressure on the lumbosacral region: In the prone position, the palms are overlapped and pressed on the lumbar spine at the painful area to the extent that no pain is caused. One breath and one breath are 1 time, and do 10 to 15 times.

(2) Rubbing and rubbing the lower back: After work, you can massage and rub the muscles of the lower back with both palms before getting up in the morning or before going to bed at night, rubbing up and down 50 to 100 times, and twisting the waist at the same time, it can relax the muscles and activate blood, and promote local blood circulation. Circulation, improve the effect of low back pain.

(3) Kneading the tendons and knots: Carefully touch the lumbar and sacrum with the pulp of the thumb, if any tender induration is found, press the pulp on it, and knead each knot for 1 minute.

(4) Pushing the lower limbs: with the help of others, prone position, fix the crotch, start from the sacrum with the base of the palm, go through the buttocks along the outer side of the thigh, the outer side of the calf, to the other side of the limb. 4. Aerobics: (1) Leg exercises: Lie on your back, hold the knee of one leg with both hands, bend the hip as much as possible, make the front of the thigh close to the abdomen, do 5 to 10 times in a row, and then do the other lower limb; then hold both knees tightly with both hands, and do 5 to 10 times at the same time. 1 time per night, or 1 time in the morning. (2) Sit-up exercises: Lie on your back and sit on your stomach. Be careful not to use the upper limbs to help, keep the lower limbs straight, and the frequency is not fixed. This exercise can also reduce abdominal fat. (3) Waist Rolling Exercise: Lie on your back, keep your legs flexed, curl your body into a ball, roll back and forth 10 to 20 times. In supine position, take a hot wet towel and no running water as the degree, pain in the waist Put a hot water bottle on top of the upper part and the sacrum slightly below, moist heat for about 10 minutes, and then put it on each side of the waist for about 10 minutes. Finally, lie on the back in the same way as the abdomen. It is especially suitable for low back pain during menstruation. allow

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