Code Of Practice For Combined Lumbar And Epidural Anesthesia

Procedure Specification for combined lumbar anaesthesia and epidural block 1. The patient was in the same position as lumbar anaesthesia

2. Puncture point L2-3 or L3-4.

3. Puncture method

Aseptic procedure requires lumbar anesthesia or epidural block. After the epidural puncture was successful, a 25G lumbar puncture needle was inserted into the epidural puncture needle guided by the epidural puncture needle. Through the epidural puncture needle opening, the arachnoid was punctured and the needle core was withdrawn. Cerebrospinal fluid was observed to flow out of the needle. 2-3ml of local anesthetic for lumbar anesthesia was randomly injected, the lumbar puncture needle was removed, the epidural puncture needle was inserted into the epidural catheter (3cm through the needle opening), the epidural puncture needle was withdrawn, the puncture point was covered with sterile gauze, and the catheter was fixed. After helping the patient to turn over and lie supine, measure the block plane of lumbar anesthesia. After 3 to 5ml of local anesthetic was injected through an epidural catheter, the operation could be started after 5 minutes without signs of hypertrophiy in the block plane. During the operation, appropriate amount of local anesthetic was injected through the epidural catheter to maintain anesthesia.

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