3 to 4 or 4 to 5 lumbar spinous process space

The dura mater and arachnoid membrane were punctured, and cerebrospinal fluid dripped out when the needle core was pulled out.

It is the most important link in subarachnoid space block.

Important factors: puncture gap height, patient position and injection speed

Common postoperative 2-7 days

Throbbing pain, headache worsens when raising head or sitting up, pain reduces or disappears when lying down

Prevention: fine needles, fluid replenishment, pillow removal, lying on your back for 4-6 days

Treatment: rest, rehydration 2500-4000, sedation, tighten the abdomen, inject normal saline glucose dextran into the extraarachnoid space

Puncture gap, anesthetic volume, catheter position and direction, concentration of solution, injection method, injection speed, patient condition and position

most serious complication

Inject all or part of the local anesthetic into the subarachnoid space

Symptoms include difficulty breathing, decreased blood pressure, confusion or loss of consciousness

Electric shock-like sensation radiating to the limbs

Stop needle insertion and adjust needle insertion direction

Epidural puncture to extract blood as soon as possible

Nitrous oxide, enflurane, isoflurane, desflurane

Thiopental, ketamine, etomidate, propofol

Reduce gastric content retention and promote gastric emptying