What Is Spinal Epidural Anesthesia What Are The Specific Steps Of Combined Spinal Epidural Anesthesia

Combined spinal-epidural anesthesia uses the characteristics of spinal anesthesia and epidural anesthesia to improve the anesthesia effect and increase the technical level of operation. It carries forward the advantages and strengths of the two, and makes up for the shortcomings and deficiencies of the two.

Advantages and benefits of combined epidural anesthesia:

Rapid onset of action; exact effect; unlimited anesthesia time; small amount of local anesthetic; low incidence of local anesthetic poisoning; postoperative epidural analgesia; true spinal anesthesia "non-contact" technique.

Steps:

1. Put the patient in the same position as spinal anesthesia

2. Take L2-3 or L3-4 for the puncture point.

3. Puncture method

Aseptic operation requires the same as spinal anesthesia or epidural block. After the epidural puncture was successful, a 25G lumbar puncture needle was inserted into the needle under the guidance of the epidural puncture needle, passed through the epidural puncture needle port, punctured the arachnoid, and withdrawn from the needle core, and the cerebrospinal fluid was seen flowing out of the needle. Randomly inject 2-3ml of local anesthetic for spinal anesthesia, withdraw from the lumbar puncture needle, insert an epidural catheter through the epidural needle (3cm through the needle port), withdraw from the epidural puncture needle, cover the puncture point with sterile gauze, and fix the catheter . After helping the patient to turn over to lie on his back, measure the level of spinal anesthesia block. Inject 3-5ml of local anesthetic through the epidural catheter. After 5 minutes, there is no sign of high block level, and the operation can be started. During the operation, an appropriate amount of local anesthesia was injected through the epidural catheter as needed to maintain anesthesia.

4. After the light or heavy specific gravity local anesthetic is injected into the subarachnoid space, it will take a period of time to perform epidural operation, which will inevitably make the block on one side of the limb significantly worse than that on the other side and affect the overall block effect. Therefore, it is often advocated that equal specific gravity local anesthesia should be used for spinal anesthesia during combined block.

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