METHOD FOR PERFORMING COMBINED SINGLE-LEVEL SEPARATE SPINAL-EPIDURAL ANESTHESIA WITH PARAMEDIAL ACCESS Russian patent published in 2021 - IPC A61B17/34 A61M19/00 A61M5/00 A61M25/01 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to anesthesiology and intensive care, and can be used for combined single-level separate spinal-epidural anesthesia with paramedial access. The epidural space is punctured with an epidural needle at a point located on the skin of the lumbar region of the back at the level of the intervertebral space L2-L3 or L3-L4 at a distance of 10 to 20 mm lateral to the medial line. The epidural needle is passed towards the spinal column at an angle of 10–20° to the sagittal plane until the ligamentum flavum is punctured. An epidural catheter is inserted through the epidural needle into the epidural space at a distance of 40–50 mm in the cranial direction. The epidural needle is removed. At the same level in the intervertebral space L2-L3 or L3-L4 at a distance of 10 to 20 mm from the medial line, the skin is punctured and the spinal needle is held at an angle of 10–20° towards the spinal column until the dura mater is punctured and a leak is obtained cerebrospinal fluid from the pavilion of the spinal needle. Then a hyperbaric solution of local anesthetic is injected through the spinal needle into the subarachnoid space. The spinal needle is removed. An epidural catheter is inserted under the skin of the lumbar region using a modified spinal needle at a distance of 70 to 80 mm in the lateral direction at an angle of 90° to the sagittal plane, and the epidural catheter is fixed with adhesive tape at the point of its exit onto the skin of the lumbar region.

EFFECT: method provides the possibility of performing epidural anesthesia in patients in whom it is impossible to carry out combined spinal-epidural anesthesia by the medial approach due to the combined spinal-epidural anesthesia with separate needles at the same level with the paramedial approach.

1 cl, 5 dwg, 1 ex