亮亮图文-医疗护士33.pptxVIP免费

蛛网膜下腔阻滞——你该知道的N件事Page2目录1.Concept2.Procedure3.Indication/Contraindication4.ComplicationsPage3目录1.Concept2.Procedure3.Indication/Contraindication4.ComplicationsConcept蛛网膜下腔截断性阻滞History1898Bier把小剂量的可卡因注射到脊髓周围的脑脊液中。在动物和人身上都取得了成功。TrendyDesignincontemporarycolorsandstyles-PowerPointTemplates&Backgrounds,PowerPointDiagrams&ChartsforyourPresentationDoctorssometimesturnouttobetheirownbestguineapigs——AnneFawcett.Page6目录1.Concept2.Procedure3.Indication/Contraindication4.Complications注药消毒铺巾摆体位定位穿刺调节平面L3侧卧位坐位Page8目录1.Concept2.Procedure3.Indication/Contraindication4.ComplicationsIndication下腹，盆腔下肢肛门会阴部2-3小时内休克过敏中枢神经系统疾病脑脊膜炎、脊髓炎、颅压升高凝血功能障碍穿刺部位炎症或感染,败血症脊椎外伤、结核精神病/严重神经官能症/小儿不能合作的病人ContraindicationPage11目录1.Concept2.Procedure3.Indication/Contraindication4.ComplicationsPage12ComplicationPuncturerelatedDruginjectionPostoperativePage13InfectionInfectionHematomaNerveRootSpinalBleedPunctureRelatedMeningitisArachnoiditisAbscess1.Backorvertebralpain2.Nerverootpain3.Motor/sensorydeficitsorsphincterdysfunction.4.Paraplegiaorparalysis.Bloodculture,CT,MRIAntibioticsPage14SpinalcordInfectionHematomaNerveRootSpinalBleedPunctureRelatedPage15NerverootInfectionNerveRootHematomaSpinalBleedPreventionObservationPunctureRelatedPage16BleedInfectionHematomaNerveRootSpinalBleed1.Venousplexus2.Pregnancy/AVM3.SubarachnoidhemorrhagePunctureRelatedPage17HematomaInfectionHematomaNerveRootSpinalBleed1.Spinal1:220,0002.Epidural1:150,0003.AbnormalcoagulationPunctureRelatedPage18DrugInjection心血管效应2呼吸抑制3马尾综合征4恶心呕吐1Page19DrugInjectionCardiacarrestLowBPPage20PhrenicnerveRespiratorydepressionDrugInjectionPage21PostoperativePostduralPunctureHeadache(PDPH)Transientneurologicsymptoms(TNS)UrinaryRetentionBackachePage22PostduralPunctureHeadache(PDPH)Treatment1.OralAnalgesics2.Bedrest3.Hydration4.Caffeineinfusion5.Epidural...