Affiliation:
1. N.I. Pirogov Russian National Research Medical University
2. Derzhavin Tambov State University; Kotovsk City Clinical Hospital
Abstract
We describe the technique of combined two-level spinal-epidural anesthesia with the use of a new method of fixing an epidural catheter in the subcutaneous canal using a modified spinal needle in the surgical treatment of hip fractures. The quality of this method of anesthesia and postoperative anesthesia depends on the reliability and safety of fixing the epidural catheter. We have developed and tested in clinical practice a method of conducting and fixing an epidural catheter in the subcutaneous canal using a modified spinal needle. The peculiarity of this method is that the modified spinal needle used can be used to conduct and fix the epidural catheter in the subcutaneous canal. The characteristics of this needle, such as small outer diameter, sharp sharpening and length from 88 to 120 mm, made the tunneling of the epidural catheter safe and fixation reliable. The new method of fixing the epidural catheter in the subcutaneous canal has reduced the number of cases with clinically significant dislocation of the epidural catheter by 2.7 times, and cases with catheter loss from the epidural space by 3 times compared to the method of fixing the epidural catheter with a patch sticker, which is the most common in anesthesiological practice.
Publisher
Tambov State University - G.R. Derzhavin
Reference16 articles.
1. Seryapina Yu.V., Fedyaev D.V., Musina N.Z. Zabolevaemost' perelomami proksimal'nogo otdela bed-rennoy kosti patsientov v vozraste 60 let i starshe v Rossiyskoy Federatsii [Incidence of proximal femur fractures in patients aged 60 years and older in the Russian Federation]. Meditsinskie tekhnologii. Otsenka i vybor – Medical Technologies. Assessment and Choice. 2020;(2):59-66. (In Russian). DOI 10.17116/medtech20204002159.
2. Bogopolskaya A.S. Sovershenstvovanie spetsializirovannoy meditsinskoy pomoshchi patsientam s pe-relomami proksimal'nogo otdela bedrennoy kosti: avtoref. dis. … kand. med. nauk [Improvement of Specialized Medical Care for Patients with Fractures of the Proximal Femur. Cand. med. sci. diss. abstr.]. St. Petersburg; 2017. (In Russian).
3. Rodionova S.S., Kolondaev A.F., Solod E.I. Kombinirovannoe lechenie perelomov sheyki bedrennoy kosti na fone osteoporoza [Combined treatment of femoral neck fractures on the background of osteoporosis]. Russkiy meditsinskiy zhurnal – Russian Medical Journal. 2004;12(24):1-8. (In Russian).
4. Wakamatsu M., Katoh H., Kondo U., et al. Combined spinal and epidural anaesthesia for orthopaedic sur-gery in the elderly. Mosul. 1991;40:1766-9.
5. Casati A., D’ambrosio A., De Negri P., Fanelli G., Tageriello V., Tarantino F. A slinical comparison be-tween needle-through-needle and double segment techniques for combined spinal and epidural anesthesia. Reg. Anesth. Pain. Med. 1998;55:3904.