How was the lumbar needle invented?

Combined spinal and epidural anesthesia has the dual characteristics of spinal anesthesia and epidural anesthesia. It has the advantages of fast onset, perfect block, good muscle relaxation and economy. At present, its clinical application has gradually increased 3. Later, it can cause physiological disturbance, the degree of which is closely related to the level of the block. The higher the level, the more obvious the disturbance. For example, after the block plane crosses the chest 10, blood pressure often drops, and in severe cases, nausea and vomiting may occur due to insufficient cerebral blood supply 4 . The block produced by CSEA was wider than expected. This may be due to the lower negative pressure and volume of the epidural space due to the subarachnoid injection, resulting in a wider spread in the plane. To avoid the wide plane, we used a subarachnoid The spinal anesthesia level was controlled below 10-11 in the chest with a small dose of heavy specific gravity local anesthesia (2ml), and a small dose of epidural administration was added to obtain a limited block level, which was quickly achieved within 30 minutes after the start of anesthesia. Infusion of 200-300ml reduces the incidence of hypotension. For hypotension after spinal anesthesia, the blood volume should be supplemented first. If it is invalid, ephedrine 15mg can be given intravenously or 30mg intramuscularly. In this group of cases, except for individual patients who were given low-dose vasopressors, the rest of the patients were all on vasopressors. All cases were operated with low-dose spinal and epidural anesthesia, which is worthy of promotion.

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