Epidural kit 29.10.2022.pptx

this slide will show you how an epidural administration of anesthesia and amnalgesia evoled through the time

1. Epidural Kit

2. Contents Epidural History Difference between anaesthesia & analgesia Indications Epidural medication delivery options Components of Epidural kit Advantage Company information Reference

3. What is an Epidural ? An epidural is a procedure that involves injecting a medication, either an anesthetic or a steroid  — into the space around your spinal nerves known as the epidural space.  Goal: provide pain relief(Analgesia) Complete lack of feeling(Anesthesia) An Epidural is commonly called the following terms: Epidural anesthesia. Epidural block. Epidural steroid injection (ESI). Regional anesthesia. Neuraxial anesthesia.

4. History In 1901-Jean-Anthanase Sicard & Fernand Cathelin Epidural anesthesia via a caudal approach In 1921- Fidel Pagés Miravé (The Spanish military surgeon) completed the lumbar approach successfully.  In 1949 - Manuel Martinez Curbelo first successful continuous lumbar Epidural anaesthesia

5. Anesthesia: Absence of all sensation, including pain, touch, temperature& pressure. Analgesia : Absence of nociceptive stimuli, with the preservation of motor& touch sensation.

6. Indication Epidurals can be used: During labor and childbirth, including caesareans during some types of surgery after some types of surgery To manage certain causes of back pain other forms of chronic pain

7. Epidural medication delivery options Single-injection epidural This type of epidural involves one injection of a medication (an anesthetic or a steroid) into the epidural space around your spine. short-term pain relief Epidural with a catheter Most epidural procedures involve the use of a catheter in your epidural space so that your healthcare provider can give you a continuous flow of anesthetic medication, multiple separate doses or both. longer operations providing pain relief over several days labor and childbirth Epidural with patient-controlled analgesia (PCA) The PCA pump is safe to use because you receive medication by pressing a button when you feel pain

8. Components of Epidural Kit An epidural kit includes : Epidural needle Epidural catheter Touhy-brost adapter Loss of Resistance syringe(LOR syringe) Other accessories

9. Epidural needle A  Tuohy (/ tOO-ee /) needle is a hollow hypodermic needle, very slightly curved at the end, suitable for inserting epidural catheters. Epidural needles are long so that we get better access to the epidural space. Material : Sainless steel 22g/50mm,80mm,100mm 20g/50mm,90mm,100mm,150mm 18g/50 mm,90mm,120mm,150mm 17g /90mm,100mm,115mm,150mm Stylet hub Winged hub Needle Markings Sizes

10. Epidural catheter An epidural catheter is a very thin, flexible tube that is implanted into your spine (specifically, your epidural space) and tunneled under your skin. Through it,  you can receive ongoing doses of medication that stops nerves in your spinal cord from sensing pain. Material : Polyamide nylon Sizes 19G/91cm, 101cm 20G/101cm 24G/72cm

11. Loss of resistance syringe(LOR syringe) The  loss of resistance syringe (LOR) is used in conjunction with an epidural needle for the purpose of identifying the epidural space. The syringes have male luer fittings, which mate to female luer fittings. Sizes: 5 ml glass 8ml plastic

12. Touhy-brost adapter A tuohy borst adapter, which is  a three-piece assembly comprised of a body, gasket and cap , is commonly used to prevent the backflow of fluid and facilitate catheter introduction.

13. 0.2 micron filter 1% Lidocan LOR syringe Catheter Tuohy brost adapter Normal salaine Epidural needle Filter needle Other Acessories

14. Advantages The advantages of getting epidural analgesia during labor and childbirth include: They are usually very effective in minimizing pain felt during labor and delivery. They are generally very safe. You can often still move around in your bed and push when you need to. If you’re experiencing prolonged labor, having an epidural helps you to sleep and recover your strength. If you're undergoing a cesarean birth (C-section), you can stay awake during the birth, and your partner can be there as well. You can usually get an epidural at any time during your labor.

15. Advantages The advantages of epidural anesthesia injections for surgery include: You’ll likely experience less nausea and vomiting than you might with general anesthesia. You’ll have a quicker recovery after the surgery than you would with general anesthesia. You may have a lower risk of developing a blood clot in one of your leg veins (deep vein thrombosis, or DVT) than you would if you had general anesthesia.

16. Advantages The advantages of epidural steroid injections include: You’ll likely experience temporary or long-term pain relief. You’ll likely have a better quality of life and an improved ability to do daily activities without the restrictions previously caused by pain. Epidural steroid injections may help confirm the origin of your pain. This is often a problem in people who have more than one possible cause of pain. Epidural steroid injections may reduce the need for more invasive procedures for pain management.

17. Risks Having low blood pressure, which can make you feel lightheaded. Experiencing a severe headache caused by spinal fluid leakage. Less than 1% of people experience this side effect. Getting an infection from the epidural procedure, such as an epidural abscess, discitis ,  osteomyelitis or meningitis. Having a negative reaction to the medications, such as hot flashes or a rash. Experiencing bleeding if a blood vessel is accidentally damaged during the injection, which could cause a hematoma or a blood clot to form. Having damage to the nerves at the injection site. Temporarily losing control of your bladder and bowels. You might need a catheter (a small tube) in your bladder to help you pee.

18. Companies Meditech Balton TUORen Satndardization Stone medical Romsons Vygon B Broun

19. Companies ICU medical Arrow Fornia

20. Reference Waurick K, Waurick R. Epiduralanästhesie - Geschichte und Technik der Epiduralanästhesie [History and Technique of Epidural Anaesthesia ]. Anasthesiol Intensivmed Notfallmed Schmerzther . 2015 Jul;50(7-8):476-82; quiz 483. German. doi : 10.1055/s-0041-100845. Epub 2015 Jul 31. PMID: 26230893. Aldrete JA, Cabrera HS, Wright AJ. Manuel Martinez Curbelo and continuous lumbar epidural anesthesia. Bull Anesth Hist. 2004 Oct;22(4):1, 4-8. doi : 10.1016/s1522-8649(04)50045-8. PMID: 20503747. Waegerle JD. Combined spinal-epidural anesthesia/analgesia. CRNA. 1999 Nov;10(4):155-64. PMID: 10723293.

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