For those whose blood pressure drops, quickly infuse 200 to 300 ml of fluid to expand blood volume.

If necessary, inject ephedrine intravenously to constrict blood vessels and maintain blood pressure.

Patients with slow heart rate can be given intravenous atropine

Oxygen, tracheal intubation, artificial respiration

Preoperative atropine prophylaxis

Treat symptomatically, such as giving oxygen, raising blood pressure, and suspending surgical traction.

If necessary, use droperidol, ondansetron and other drugs for prevention and treatment

Usually occurs 2-7 days after surgery

reason

Performance

prevention

deal with

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

After the patient is injected with the drug, he quickly develops difficulty breathing, a drop in blood pressure, confusion or disappearance of consciousness, and even breathing and cardiac arrest.

Strictly abide by operating procedures

Aspirate the cerebrospinal fluid before injecting the medicine

When injecting, use the test dose to confirm that it has entered the subarachnoid space before continuing the administration.

Stop medication immediately

Positive pressure ventilation with a new mask, and endotracheal intubation to maintain breathing if necessary

Speed ​​up the infusion rate and give vasopressors as directed by the doctor to maintain circulatory function.

The puncture needle may cause direct trauma or damage to the spinal nerve roots or spinal cord due to the hardness of the catheter.

The patient has an electric shock-like sensation or radiates to the limbs

The patient develops local sensory or/and motor disturbances

Stop the competition immediately and adjust the needle insertion direction to avoid aggravating the injury.

People with prolonged paresthesia may suffer serious injuries, so block anesthesia should be abandoned.

Patients with spinal nerve root injuries will receive symptomatic treatment and will heal spontaneously within a week or a few months of surgery.

Damage to blood vessels during epidural puncture and catheterization

Severe back pain, progressive spinal cord compression symptoms, accompanied by muscle weakness, urinary retention sphincter dysfunction, hematoma compressing the spinal cord, and paraplegia may occur

This morning I will perform an extra-membranous puncture to draw out the blood, and if necessary, cut the lamina and remove the hematoma.

Ankylosis of the lamina ligaments and paravertebral muscles or improper catheter placement technique, poor catheter texture, and improper force on the catheter

The catheter is difficult to remove or breaks during removal

Subject: It is difficult to extubate the tube. Do not use violence. You can put the patient on the edge, apply heat in the puncture position or inject local anesthetic around the tube before pulling it out.

If the catheter is broken, patients without infection or nerve irritation symptoms do not need to take it out, but due to close observation