FIELD: medicine.
SUBSTANCE: spinous process of the first lumbar vertebra is determined and the 7-8 cm distance to the left, where the lateral margin of the paravertebral muscles crosses the lower margin of the twelfth rib, is marked. The local anesthesia is performed in this area with 2 ml 2% lidocain, the 16 G 200 mm needle is injected medially towards the L1 vertebral body at angle of 30 degrees to the sagittal plane. When the needle is set against the L1 vertebral body at 8-12 cm in depth, it is pulled 0.5-1 cm back and then directed more laterally ahead, so as the needle's end is located 1.5-2 cm in front of the anterior margin of the L1 vertebral body. The aspiration sampling is taken for presence of blood or cerebrospinal fluid and if the result is negative, the blockade is performed with 3-4 ml 2% lidocain. If in 7-10 min pain is reduced without sensor or motor blockade, the epidural catheter for continuous administration of medicines is inserted via the installed needle.
EFFECT: pain syndrome is reduced while narcotic analgesics are avoided.
2 ex, 5 dwg, 1 tbl
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Authors
Dates
2008-05-20—Published
2006-03-16—Filed