First, let’s first talk about half -body anesthesia?
Half -body anesthesia schematic diagram
Half -body anesthesia is to inject mochi medicine to a specific area in the spinal canal through fine needles, thereby producing anesthesia effects of sympathetic nerve block, analgesic, muscle loose, and disappearing.According to the different injection drug areas, the anesthesia of the half body is divided into sub -absorbers, anneminal anesthesia, and sacral anesthesia.Half -body anesthesia inlet process is the skin, inter -spine ligament, yellow ligament, outer membrane, duct, hard spinal membrane, alays, alatrome, and subeter subaginal cavity.Position the needle tip in the outer gap of the duct, the hemp medicine of the incense produces an extra -hardening effect, the needle tip is positioned in the subaraidial cavity.There is no cerebrospinal fluid in the hydrocyrgyer cavity, which is a negative pressure; the subaraliaous cavity has cerebrospinal fluid, which is positive pressure. After the needle tip is reached, there can be clear cerebrospinal fluid flowing out.The anesthesia drug produces anesthesia through the use of spinal nerves.
Anatomy of spine spinal canal
2. What patients are suitable for half -body anesthesia?
Almost all surgery below the neck can be completed through half -body anesthesia, but complications such as respiratory suppression and spinal cord injury in high -level spinal anesthesia, so it is less used.Half -body anesthesia can be used not only alone, but also compounded with systemic anesthesia. For example, thoracic surgery surgery, systemic anesthesia composite ductal anesthesia, facilitating the management of analgesia during surgery and postoperative surgery.In clinical clinical clinic, internal spinal anesthesia of the chest and waist can be applied to the types of surgery such as lower limb surgery, hernia, urinary system surgery, and caesarean section.So which patients are not suitable for half -body anesthesia?1) Reject itself; 2) serious mental insufficiency; 3) coagulation incomplete; 4) Pingling site infection; 5) hypotension shock and other circumstances.
Third, the headache of half -body anesthesia complications
There are many complications of half -body anesthesia. There may be urinary retention, hypotension, back pain, headache, whole spine, neuropathy, bleeding, infection, etc., and there are many complications, but the incidence is relatively low.Today I will focus on the topic of headache. The professional term of headache after half -body anesthesia is the headache after the ductive spine breaks.Main manifestations: bilateral foreheads or rear orbital parts, pillows, can be radiated to the neck, for persistence or intermittent fighting headache.Symptoms and positions have obvious correlations. When sitting or standing, they are worsened. They are alleviated during the flat position, which appears more than after anesthesia. It can last for several weeks.The pathogenesis: The exact mechanism is unclear. The more supportive point of view is that when the spinal anesthesia is implemented, the puncture needle causes the spider -sarmeal and the ductal diaphragm damage to break the mouth, and the outflow of the cerebrospinal fluid is lost to cause headaches.The cerebrospinal liquid is lost out of the rocketer of the alays. Decreased intracranial cerebral spinal fluid will cause intracranial pressure to decrease, resulting in the structure of mechanical pulling the brain, such as the pain sensitive structure of pain in the cranial nerve and meningus.When the patient stands, the intracranial and peripheral venous pressure differences plus the pain; when lying, the venous pressure difference is reduced to relieve headache.Good people: Patient risk factors include women, pregnancy, previous headaches, low intracranial pressure and low weight.Pregnancy is proven to be an independent risk factors for headaches after a hard membrane anesthesia, so it is often heard that pregnant women complain about headache after giving birth.The level of estrogen after pregnancy, the level of estrogen can increase the vascular tension, and is more sensitive to changes in the pressure of the cerebrospinal fluid.The second output will increase the risk of cerebral spine pressure to increase the risk of cerebral leakage and increase the size of the hard spine.The operating factors include the type of puncture needle, the method of puncture, the position of the patient.The size of the puncture needle, the type of needle, and the direction of the puncture will affect the incidence of headaches.The types of puncture needle include the slope and the pen tip. The inclined needle tip is more damaged to the ductal membrane, and the higher the risk of headache.The thicker the model of the puncture needle, the greater the damage.When using a slashed needle, the direction of the needle tip can reduce damage when parallel with the long axis of the hard spinal membrane.
Type -type treatment method: bed rest, liquid management, and blood patch are more commonly used treatment methods.Although bed rest cannot prevent headaches; however, it does alleviate the severity of headaches and make it a certain value.Blood patch is an effective treatment method for headaches after the hard spinal membrane is broken. By injecting 10-20ml of blood by injecting its own blood by injecting its own blood, the blood coagulation block is used to repair the broken mouth to reduce the leakage of the cerebrospinal fluid.For a long time, blood patch has been a gold standard for treatment. After treatment, patients usually immediately feel the relief of pain, and are suitable for patients with invalidation of conservative treatment.Drug therapy is one of the conservative methods for alleviating headaches, including non -steroidal anti -inflammatory drugs, caffeine, etc.
