Friday, June 22, 2012

PROCEDURE EPIDURAL 1

EPIDURAL ANESTHESIA
Objectives
· To provide anesthesia for procedures and surgical inter­ventions (i.e., urological, gynecological, obstetrics, abdominal and orthopedic surgeries) by introducing local anesthesia into the epidural space.
· This technique is also used for providing postoperative analgesia.
· Written consent for procedure is required.
Position
Same as for spinal anesthesia.
Premedication
Oral premedication given.
Procedure
1. Procedure explained to the patient.
2. On a tiltable table.
   3. Performed at any level of spinal cord according to the desired level of analgesia.
   4. Thoracic, lumbar or caudal epidural practiced.
   5. The duration of action can be prolonged by intermittent
       injections through an epidural catheter.
   6. Epidural needles are thick and curved tips (16, 18, 20 G)
   7. Intravenous line started.
   8. Patient attached to ECG, Sp02 and NIBP monitor.
   9. Scrub and wear sterile gown and gloves.
  10. Check the epidural set on the sterile trolley for the items required, proper size needle and catheter;           proper fitting of syringe into the hub of epidural needle.
  11. Fill in a 20 ml syringe the local anesthesia to be injected into the epidural space.
  12. Read the label of drug vial carefully for the name,percentage, baricity, expiry date. Confirm it with       assistant.
13. Local anesthetic to be used for skin infiltration taken into a
2 ml syringe (2 cc. 2% xylocaine)

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