What is the specific step of combined anesthesia of lumbar hard anesthetic needle lumbar hard

Combined lumbar and epidural anesthesia is the use of the characteristics of lumbar anesthesia and epidural anesthesia, so that the anesthetic effect is improved and the level of operation technology increased. It develops the advantages and strengths of both, and makes up for the shortcomings and deficiencies of both.

Advantages and advantages of combined epidural anesthesia:

Rapid onset of action; The effect is exact; The time of anesthesia is not limited; Local anesthetic dosage is small; The incidence of local anesthetic poisoning is low; Postoperative epidural analgesia; True lumbar anesthesia "no contact" technology.

Operation Procedure:

1. Place the patient in the same lumbar position

2. The puncture point was L2-3 or L3-4.

3. Puncture method

Epidural or epidural block is required for the aseptic procedure. After successful epidural puncture, a 25G lumbar puncture needle was inserted into the needle under the guidance of the epidural puncture needle, and the arachnoid membrane was punctured to exit the needle core. Cerebrospinal fluid was seen to flow out of the needle. 2-3ml local anesthetic for lumbar anesthesia was randomly injected, and the lumbar puncture needle was withdrawn. The epidural catheter was inserted through the epidural puncture needle (3cm through the needle opening). The epidural puncture needle was withdrawn, and the puncture point was covered with sterilized gauze to fix the catheter. After helping the patient turn supine, measure the block level of lumbar anesthesia. After injection of 3-5ml local anesthetic through the epidural catheter, the operation can be started without signs of high block plane after 5 minutes. During the operation, appropriate amount of local anesthetic was injected through the epidural catheter as needed to maintain anesthesia.

4. Due to the injection of light or heavy local anesthetics into the subarachnoid space, it still needs a period of time for epidural operation, which is bound to cause significant block on one side of the limb and poor on the other side and affect the whole block effect. Therefore, it is recommended to use local anesthetic with equal specific gravity when combined block.

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