Epidural Epidural anesthesia

Epidural Epidural anesthesia epidural or epidural anesthesia is the introduction of local anesthetic into the epidural space, thus blocking the nerve endings in his departure from the core. Thus its distribution will be metameric, that is it numb the body part corresponding to the nerves that have been made by the local anesthetic injected. It was discovered by Spanish Fidel Pag s. The epidural puncture technique is performed with the patient sitting position or lateral position and punctured the space between the posterior processes of the vertebra. The puncture level is a function of the area to be anesthetized. Lumbar puncture, which is the most common, is made in the vertebral space between two lumbar vertebrae and the abdominal area is anesthetized. Epidural anesthesia was performed by mediating various techniques. All of them consist in finding the epidural space. This is a virtual space that lies outside the dura.By anesthetizing the skin at the puncture, a needle is attached to a syringe filled with little resistance from air or water. He is introduced and the needle is pushing the plunger of the syringe. While going through muscle or ligaments produces a resistance to push the plunger. On reaching the epidural space that resistance disappears and empties the air or water. This is the sign that we have reached the epidural space. In introducing the drug to be administered and the catheter if necessary. Epidural anesthesia is indicated for those interventions especially at the abdomen infraumbilical, such as inguinal hernias, testicular or bladder interventions or childbirth. Appendicitis corresponding to this area is not a good indication as though the skin where it corresponds to the area, the appendix and adjacent bowel are innervated by nerves from levels above the anesthetized area and pull the intestine may be soreness.Regarding spinal anesthesia has the advantage that you can insert a catheter into the epidural space which can be reinjecting drug or introduce a continuous infusion to produce a continuous and prolonged anesthesia. It is therefore useful for long speeches or for postoperative analgesia. Drugs that are injected into the epidural space are varied but are mainly local anesthetics. Such an effect depending on dose. In small doses block the fibers that transmit pain. At higher doses produce neuromuscular blockade and paralysis. And the higher the dose sensory blockade. Other drugs used are different from morphine. Today has published several papers on the injection of different drugs and epidural clonidine or ketamine, intravenous drug use but has been shown to also act at the level of the nerve fiber.The association of two epidural drug potentiates the action of both minimizing their side effects by allowing dose reduction. In recent years is widely used thoracic epidural anesthesia is the same technique but at the level of the thoracic vertebrae. This will produce analgesia from higher areas to those achieved with lumbar epidural anesthesia and is mostly used for postoperative analgesia after upper abdominal surgery or thoracic surgery. Epidural anesthesia is contraindicated in cases of childbirth in which the expansion is too advanced, in cases of lower back tattoos on their location and function in patients with certain conditions such as obedient or heart disease.