亮亮图文-医疗护士33.pptx

蛛网膜下腔阻滞你该知道的N件事,目录,1.Concept,2.Procedure,3.Indication/Contraindication,4.Complications,目录,1.Concept,2.Procedure,3.Indication/Contraindication,4.Complications,Concept,蛛网膜下腔,截断性阻滞,History,Trendy Design in contemporary colors and styles-PowerPoint Templates&Backgrounds,PowerPoint Diagrams&Charts for your Presentation,Doctors sometimes turn out to be their own best guinea pigsAnne Fawcett.,目录,1.Concept,2.Procedure,3.Indication/Contraindication,4.Complications,注药,消毒铺巾,摆体位,定位,穿刺,调节平面,蛛网膜下腔阻滞流程图,L3,目录,1.Concept,2.Procedure,3.Indication/Contraindication,4.Complications,Indication,下腹，盆腔,下肢,肛门会阴部,2-3小时内,Contraindication,目录,1.Concept,2.Procedure,3.Indication/Contraindication,4.Complications,Complication,Infection,Infection,Hematoma,Nerve Root,Spinal,Bleed,Puncture Related,Meningitis ArachnoiditisAbscess,1.Back or vertebral pain2.Nerve root pain3.Motor/sensory deficits or sphincter dysfunction.4.Paraplegia or paralysis.,Blood culture,CT,MRI,Antibiotics,Spinal cord,Infection,Hematoma,Nerve Root,Spinal,Bleed,Puncture Related,Nerve root,Infection,Nerve Root,Hematoma,Spinal,Bleed,Prevention,Observation,Puncture Related,Bleed,Infection,Hematoma,Nerve Root,Spinal,Bleed,1.Venous plexus2.Pregnancy/AVM3.Subarachnoid hemorrhage,Puncture Related,Hematoma,Infection,Hematoma,Nerve Root,Spinal,Bleed,1.Spinal 1:220,0002.Epidural 1:150,0003.Abnormal coagulation,Puncture Related,Drug Injection,Drug Injection,Cardiac arrest,Low BP,Phrenic nerveRespiratory depression,Drug Injection,Postoperative,Postdural Puncture Headache(PDPH),Transient neurologic symptoms(TNS),Urinary Retention,Backache,Postdural Puncture Headache(PDPH),Treatment 1.Oral Analgesics 2.Bed rest 3.Hydration 4.Caffeine infusion 5.Epidural blood patch,1.Frontal/Occipital2.Tinnitus/Diplopia3.Upright position,Backache,1.Benign,mild and self-limited2.Tylenol,ASA,NSAIDs,warm or cold packs,Clinical sign of a more serious complication?,1.Block of S2-S4 root 2.Opioids,Urinary Retention,TreatmentCatheterization,Transient neurologic symptoms(TNS),