METHOD FOR FIXING AN EPIDURAL CATHETER UNDER THE SKIN OF THE LUMBAR REGION Russian patent published in 2023 - IPC A61B17/34 A61M19/00 

FIELD: medicine.

SUBSTANCE: invention relates to anesthesiology and intensive care, and can be used to fix an epidural catheter in the subcutaneous canal. The invention relates to medicine, namely to anesthesiology and intensive care, and can be used to fix an epidural catheter in a subcutaneous canal. A large subcutaneous canal is formed from the site of epidural access to the exit of the epidural catheter to the skin surface by passing an epidural Tuohy needle with an outer diameter of 1.3 mm and a length of 80 mm under the skin of the lumbar region through a skin wound of 5 mm in size at the site of epidural access in the lateral direction under angle 90° to the sagittal plane at a distance of 75 mm to the first exit of the distal end of the epidural needle to the skin surface. Then, a spinal needle with an outer diameter of 0.5 mm and a length of 103 mm is passed through the lumen of the epidural needle in the direction from the distal end to the proximal end of the epidural needle, so that the distal end of the spinal needle is located in the lumen of the epidural needle in the area of the epidural needle pavilion. The epidural needle is removed from under the skin of the lumbar region, while the spinal needle remains in the formed large subcutaneous canal. The distal end of the spinal needle is fixed with a mosquito-type surgical clamp. The distal end of the spinal needle, with a Pencil Point type, is passed into the lumen of the proximal end of the epidural catheter at a distance of 5 mm, the spinal needle with the epidural catheter fixed on it is removed from the large subcutaneous canal until the epidural catheter is completely immersed under the skin of the lumbar region until the first exit of the epidural catheter to the surface of the skin from the large subcutaneous canal. A small subcutaneous canal is formed by passing the same epidural Tuohy needle with an outer diameter of 1.3 mm and a length of 80 mm under the skin of the lumbar region from a point located 5 mm lateral from the place of the first exit of the epidural catheter to the skin surface from the large subcutaneous canal in the caudal direction at a distance of 10 mm to the second exit of the distal end of the epidural needle to the skin surface. The same spinal needle with an outer diameter of 0.5 mm and a length of 103 mm is passed in the cranial direction with a pencil sharpening of the distal end of the needle, of the “Pencil Point” type, through the lumen of the epidural needle in the direction from the distal end to the proximal end of the epidural needle, so that the distal end of the spinal needle would be located in the lumen of the epidural needle pavilion. The epidural needle is removed from under the skin of the lumbar region, while the spinal needle remains in the formed small subcutaneous canal. The distal end of the spinal needle is fixed with a mosquito-type surgical clamp. The distal end of the spinal needle, with a Pencil Point type, is passed into the lumen of the epidural catheter at a distance of 5 mm, the spinal needle with the epidural catheter fixed on it is removed from the small subcutaneous canal, so that the epidural catheter is completely located under the skin of the lumbar area up to the second exit of the epidural catheter to the surface of the skin from the small subcutaneous canal. After that, the proximal end of the epidural catheter is passed between the skin surface and the skin area of the epidural catheter located between the first exit of the epidural catheter to the skin surface from the large saphenous canal and the entry of the epidural catheter into the small saphenous canal, thus forming a subcutaneous loop of the epidural catheter. After that, the proximal end of the epidural catheter is passed into the lumen located between the skin surface and the skin area of the epidural catheter between the place of the second exit of the epidural catheter to the skin surface from the small saphenous canal and the place of the first exit of the epidural catheter to the skin surface from the large saphenous canal, thus forming way, the cutaneous loop of the epidural catheter.

EFFECT: method is safe as there is no risk of damage to the epidural catheter and no modification of the epidural needle and spinal needle is required.

1 cl, 13 dwg, 1 ex