Abstract: Objective To observe epidural pressure dynamic graph and liquid reflow as an indication to direct epidural anesthesia. Meanwhile, study its reliability, accuracy. Methods 1200 patients undergone epidural anesthesia were enrolled. According to epidural puncture segment, they were divided into 6 groups(n=200, each): Cervical Group (C4-5/C5-6/C6-7, Group C), Thoracic GroupⅠ(T3-4/T4-5, Group T1), Thoracic GroupⅡ(T8-9/T9-10, Group T2), Thoracic GroupⅢ(T10-11/T11-12, Group T3), Lumbar GroupⅠ(T12-L1/L1-2, Group L1), Lumbar GroupⅡ(L2-3/L3-4, Group L2). Epidural anesthesia equipments include: transducer, 3-way stopcock. Continuously recorded the pressure graph. All patients were punctured by normal beam testing. The puncture needle was fixed to supraspinous ligament; a 3-way stopcock was connected to the end of the epidural needle and the transducer. Needling slowly, meanwhile observe the pressure graph, decreased (breakthrough sensation appeared or not), pressure graph appeared curved waveform, draw 3ml saline with syringe through 3-way stopcock, no bubble compress can testify the success. Insert the epidural tube to 15cm, then according to the graph, left 3cm deep in epidural space, and fixed the tube. Epidural tube and physic liquid reflow scope were connected by the 3-way stopcock. Observe the character of reflow liquid (-clear, +week red, ++obviously red, +++deep red, ++++redness) and pressure graph for 5minutes. There were no indications of abnormal, infused the different concentration and dose of drug as normal. Continuously observe the character of reflow liquid, pressure graph, anesthesia effect and complications. Results 1.Pressure graph character: before breakthrough the ligament flavum, pressure numerical values suddenly increased(zoomed to 82.00±25.61mmHg), When punctured into ligament flavum, a sudden drop in the pressure readings to 6.51±11.59mmHg, specific graph linearly retray 100%. Epidural space pressure compared with ligament flavum pressure, which was obviously decreased (P<0.05). There were no complications in the study. Conclusion Epidural pressure dynamic graph and liquid reflow as an indication to direct epidural anesthesia, is reliable and accurate. It is facilitated in every epidural scope and every age in security and validity, avoid and prevent complications effectively, generalize epidural anesthesia application.
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