Epidural Tuohy Punture Cannula

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What is the difference between lumbar puncture and epidural anesthesia?

Lumbar puncture is actually the traditional name for subarachnoid puncture.

First of all, subarachnoid puncture mainly refers to an invasive examination procedure, which is clinically used to extract cerebrospinal fluid for relevant examination, but it can also be anesthetized by injecting local anesthetic drugs by subarachnoid puncture (also known as "subarachnoid block" or "lumbar anesthesia").

Perhaps many people do not understand that subarachnoid block and epidural anesthesia are not injected on the back. What's the difference between the two?

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Epidural Tuohy Punture Cannula

In fact, these two kinds of anesthesia are collectively referred to as intraspinal anesthesia. The anatomical levels in the spinal canal are ligamentum flavum, spinal dura, arachnoid and spinal cord. Between the ligamentum flavum and the spinal dura is the epidural space, and placing the anesthetic here is called epidural anesthesia. While there is an underlying anatomical gap between the dura and arachnoid membranes that is generally not clinically distinguishable, there is a gap between the arachnoid membranes and the spinal cord called the subarachnoid space. So one of the differences between these two types of anesthesia is the level of injection.

More importantly, there are differences in the duration, location and dose of anesthesia between the two groups. The duration of subarachnoid block anesthesia is short, the safe anesthesia site is low (usually only used for abdominal anesthesia and below), and the dose is relatively low (the main complication is headache caused by intracranial hypotension, but the recent improvement of instruments has reduced the risk of this kind of anesthesia). Epidural anesthesia can support longer operation time and can even be used for postoperative analgesia. The safe anesthetic site is high (it was even used for neck surgery in the early stage), but the dose is high (and the technical requirements of the operator are high, which may lead to the risk of complications of general spinal anesthesia).

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