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Although this procedure is categorized as "minimally invasive", post-operative pain control can be quite challenging, thus requiring multi-modal pain management including epidural anesthetics. Nurses who attend these patients post operation generally concur that this operation is one of the more difficult recoveries of any operations for children.
Medical intervention Epidural administration A freshly inserted lumbar epidural catheter. The site has been prepared with tincture of iodine, and the dressing has not yet been applied. Depth markings may be seen along the shaft of the catheter. ICD-9-CM 03.90 MeSH D000767 OPS-301 code 8-910 [edit on Wikidata] Epidural administration (from Ancient Greek ἐπί, "upon" + dura mater) is a method ...
Caudal anaesthesia is a relatively low-risk technique [4] commonly used, either on its own or in combination with sedation or general anaesthesia. [3] [5]Caudal anesthesia may be favored for sub-umbilical region surgeries in the pediatric population, such as inguinal hernia repair, circumcision, hypospadias repair, anal atresia, or to immobilise newborns with hip dysplasia.
Intrathecal administration is often used for a single 24-hour dose of analgesia (opioid with local anesthetic). Caution should be exercised with intrathecal opioids due to the risk of late onset hypoventilation. The use of intrathecal morphine may be limited by severe pruritus and urinary retention. [citation needed]
Some patients may be more resistant to the effects of anesthetics than others; factors such as younger age, obesity, tobacco smoking, or long-term use of certain drugs (alcohol, opioids, or amphetamines) may increase the anesthetic dose needed to produce unconsciousness. There may be genetic variations that cause differences in how quickly ...
Types of epidural needles include: [3] The Crawford Needle; The Tuohy Needle; The Hustead Needle; The Weiss Needle; The Sprotte Spezial Needle; Other Epidural Needles : Other less popular types are the Wagner needle (1957), the Cheng needle(1958), the Crawley needle (1968), the Foldes needle (1973), and the Bell needle (1975)—all variants of the Huber design with a blunted tip of varying ...
A small dose of local anaesthetic (e.g. bupivacaine) is then instilled. An opioid such as fentanyl may also be given if desired. The spinal needle is then withdrawn and the epidural catheter inserted in the standard manner. Alternatively, a two-level approach may be undertaken. The epidural space is first located in the standard manner.
Between them is the epidural space. The two layers of the dura mater separate at several places, with the meningeal layer projecting deeper into the brain parenchyma forming fibrous septa that compartmentalize the brain tissue. At these sites, the epidural space is wide enough to house the epidural venous sinuses. [2] [4] [5]