Epidural anesthesia (NURSING FOUNDATION)

ANESTHESIA (EPIDURAL ANESTHESIA), PROCEDURE

1. Epidural anesthesia is are regional anesthesia that blocks pain in particular region of the body . The goal of an epidural is to provide analgesia , or pain relief , rather than anesthesia ,which leads to total lack of feeling . Epidural blocks the nerve impulses from the lower spinal segments. This results in decreased sensation in the lower half of the body. EPIDURAL ANESTHESIA-

2. 1-CERVICAL EPIDURAL 2- THORACIC EPIDURAL 3- LUMBAR EPIDURAL 4-CAUDAL EPIDURAL TYPES

3. All Operation below diaphragm May be used in – 1- poor risk patient 2- cardiac disease 3- pulmonary diseases 4- metabolic disturbances 5- when spinal anesthesia is contraindicated 6- painful conditions including post op condition INDICATION

4. SEVERE HEMORRHAGE COAGULATION DEFECT PREVIOUS LEMINECTOMY UNCOOPERATIVE LOCAL INFALMMATION AT SITE PATIENT REFUSAL CONTRAINDICATION

5. WELL DEFINED AREA OF ANESTHESIA LONGER DURATION MORE SEVERE DISTURBANCES OF SPINAL ANESTHESIA MINIMIZED GI COMPLAINS MINIMIZED CATHETERIZATION MINIMIZED LESS RESPIRATORY EFFECTS ADVANTAGES

6. TECHNICALLY MORE DIFFICULT MUSCLE RELXATION NOT COMPLETE LARGE VOLUME NECESSARY DANGER OF DURAL PUNCTURE PATCHY BLOCK DISADVANTAGES

7. HEIGHT OF PATIENT DRUGS USED VOLUME CONCENTRATION LEVEL OF PUNCURE AND CATHETER INSERTION FACTORS INFLUENCING SPREAD OF SOLUTION

8. METHOD- 1-SINGLE DOSE INJECTION 2- FRATIONAL – CONTINOUS EPIDURAL – REPEATED INJECTIONS OF LA THOUGH CATHETER INSERTED INTO EPIDURAL SPACE TECHNIQUE

9. CERVIC AL EPIDURAL –SITTING (C7) THORACIC EPIDURAL (T7) LUMBAR EPIDU LATERAL(L1-L2,L2-L3,L3-L4,L4-L5) LATERAL DECUBITUS ,FULL FLEXION POSITION

10. 25 GAUZE NEEDLE FOR SKIN ANALGESIA . 4 CM ,22 GAUZE NEEDLE FOR DEEP INFILTRATION . 18 GAUZE FOR EPIDURAL EPIDURAL CATHETER NORMAL SALINE INJECTION DRUGS SYRINGES EQUIPMENT

11. HAND WASH WEAR GLOVES THE SKIN OVER THE INJECTION SITE IS MARKED AND CLEANED WITH BETADINE A FLUOROSCOPIC X-RAY IS USED TO LOCATE THE CORRECT VERTEBRAL LEVEL FOR NEEDLE A LOCAL ANESTHESIA IS INJECTED INTO THEVSKIN AND UNDERLYING TISSUES TO NUMB THE AREA PROCEDURE

12. AN EPIDURAL SPINAL NEEDLE IS INSERTED INTO THE INTENDED INJECTION SITE AND GUIDED USING FLUOROSCOPY A CONTRAST DYE IS INJECTED INTO THE EPIDURAL SPACE TO CHECK THE SPREAD OF THE INJECTED CONTENTS ONCE THE SPREAD IS CONFIRMED , THE STEROID MEDICATION IS INJECTED INTO THE EPIDURAL SPACE CONTINUE…

13. A TINGLING OR MID BURNING SENSATION OR THE FEELING OF PRESSURE MAY BE EXPERIENCED AS THE MEDICATION ENTERS THE EPIDURAL SPACE WHEN THE IJECTION IS COMPLETED , THE IRRITATION AND DISCOMFORT USUALLY DISAPPEAR WITHIN A FEW MINUTES . THE PATIENR IS USUALLY MONITORED IN A RECOVERY ROOM FOR 30 MINUTE TO AN HOUR WHERE VITAL SIGNS ARE CONTINUOUSLY MONITORED CONTINUE….

14. DRIVING AND STRENUOUS PHYSICAL ACTIVIES AND FLYING IN AN AIRPLANE ARE NOT RECOMMENDED ON THE SAME DAY AFTER THE PROCEDURE. CONTINUE…

15. THANK YOU