-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
-
Cosmetic Ingredient
- Water Treatment Chemical
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
The story has to start with a labor analgesia two weeks ago.
It was a Friday when there were not many operations.
My operation was over at around 3pm and I was about to visit the patient on the next Monday.
At this time, the hospital instructor instructed a woman in the delivery room to give birth pain relief, and I received the order to prepare quickly.
The necessary items rushed to the delivery room.
Childbirth analgesia has been fully developed in our hospital for more than a year.
I think I belong to the puncture cleanly and hit with a single blow.
The puerpera is 24 years old, 160cm/58kg, and the puncture conditions are very good.
After talking to the puerpera and her family quickly, she started the operation.
After the epidural needle is punctured to the ligament, the needle is slowly inserted until a sense of breakthrough occurs and the pressure disappears.
At this time, the mother begins to contract.
I will suspend the operation and wait for the contraction to disappear, then turn around to prepare the epidural catheter, but it is almost Turned around in seconds and found that a large amount of liquid was pouring out of the epidural needle! Really, at that moment, I was terrified.
.
.
then I pulled out the epidural needle and touched the temperature of the outflowing liquid at the same time, it was determined that the cerebrospinal fluid was correct and the epidural was penetrated! Soon, many thoughts flashed in my mind as to whether to continue communicating with the patient, whether to talk about headaches caused by dural puncture before the operation, whether to change the gap and re-puncture the catheter, and a large amount of epidural drugs into the subarachnoid to cause the whole spine What to do with anaesthesia.
.
.
After thinking for a while, I decided to confess with the patient, but suggested that labor analgesia can still be done, and the effect is even better; but the patient clearly refused and fell into a breakdown.
Later, I calmed down and thought about it.
At this time, the confession was indeed open to question, and it was suspected of shirking responsibility.
After detailed explanation and communication, the parturient gradually calmed down; after 3 hours, the labor process accelerated and the pain became more obvious.
I took the initiative to communicate with the parturient and the puncture was still possible.
She also expressed her willingness, but the obstetrician found that the uterine mouth had been opened to 6 Means, it is estimated that it will be delivered soon, it is recommended not to puncture temporarily, as expected, the delivery will go smoothly within 2 hours. After giving birth, I started to go to the pillow and supine and replenish a lot of fluids.
Since there has been no clear headache, I tried to shake the head by 10 degrees after 48 hours after giving birth.
After 10 minutes, I developed obvious headaches.
The pain disappeared after shaking, and the typical manifestation of low intracranial pressure.
After communicating with the patient, he decided to treat the patient conservatively for another 24 hours.
If it fails, he will use the epidural autologous blood filling (EBP); as expected, the next day, the hard head reappeared after 10 degrees of head shaking.
Headache (PDPH) after membrane puncture, so EBP was started.
Push the patient into the operating room and sign the informed consent.
The superior doctor in the lateral position decided to perform the puncture at the same puncture point.
The process went smoothly.
20ml of peripheral venous blood was taken.
After slowly pushing in, the needle was pulled out and changed to the prone position for 10 minutes.
The whole process was not obvious.
Feel unwell, send back to the ward.
The patient complained that the headache was significantly improved.
After 24 hours, the head shook again and no headache recurred.
He was discharged 2 days later and had no discomfort during follow-up.
Regarding PDPH, it is not clinically new.
There are no wet shoes when walking along the river.
You will eventually encounter more punctures.
This article does not discuss the mechanism and treatment of PDPH (
It was a Friday when there were not many operations.
My operation was over at around 3pm and I was about to visit the patient on the next Monday.
At this time, the hospital instructor instructed a woman in the delivery room to give birth pain relief, and I received the order to prepare quickly.
The necessary items rushed to the delivery room.
Childbirth analgesia has been fully developed in our hospital for more than a year.
I think I belong to the puncture cleanly and hit with a single blow.
The puerpera is 24 years old, 160cm/58kg, and the puncture conditions are very good.
After talking to the puerpera and her family quickly, she started the operation.
After the epidural needle is punctured to the ligament, the needle is slowly inserted until a sense of breakthrough occurs and the pressure disappears.
At this time, the mother begins to contract.
I will suspend the operation and wait for the contraction to disappear, then turn around to prepare the epidural catheter, but it is almost Turned around in seconds and found that a large amount of liquid was pouring out of the epidural needle! Really, at that moment, I was terrified.
.
.
then I pulled out the epidural needle and touched the temperature of the outflowing liquid at the same time, it was determined that the cerebrospinal fluid was correct and the epidural was penetrated! Soon, many thoughts flashed in my mind as to whether to continue communicating with the patient, whether to talk about headaches caused by dural puncture before the operation, whether to change the gap and re-puncture the catheter, and a large amount of epidural drugs into the subarachnoid to cause the whole spine What to do with anaesthesia.
.
.
After thinking for a while, I decided to confess with the patient, but suggested that labor analgesia can still be done, and the effect is even better; but the patient clearly refused and fell into a breakdown.
Later, I calmed down and thought about it.
At this time, the confession was indeed open to question, and it was suspected of shirking responsibility.
After detailed explanation and communication, the parturient gradually calmed down; after 3 hours, the labor process accelerated and the pain became more obvious.
I took the initiative to communicate with the parturient and the puncture was still possible.
She also expressed her willingness, but the obstetrician found that the uterine mouth had been opened to 6 Means, it is estimated that it will be delivered soon, it is recommended not to puncture temporarily, as expected, the delivery will go smoothly within 2 hours. After giving birth, I started to go to the pillow and supine and replenish a lot of fluids.
Since there has been no clear headache, I tried to shake the head by 10 degrees after 48 hours after giving birth.
After 10 minutes, I developed obvious headaches.
The pain disappeared after shaking, and the typical manifestation of low intracranial pressure.
After communicating with the patient, he decided to treat the patient conservatively for another 24 hours.
If it fails, he will use the epidural autologous blood filling (EBP); as expected, the next day, the hard head reappeared after 10 degrees of head shaking.
Headache (PDPH) after membrane puncture, so EBP was started.
Push the patient into the operating room and sign the informed consent.
The superior doctor in the lateral position decided to perform the puncture at the same puncture point.
The process went smoothly.
20ml of peripheral venous blood was taken.
After slowly pushing in, the needle was pulled out and changed to the prone position for 10 minutes.
The whole process was not obvious.
Feel unwell, send back to the ward.
The patient complained that the headache was significantly improved.
After 24 hours, the head shook again and no headache recurred.
He was discharged 2 days later and had no discomfort during follow-up.
Regarding PDPH, it is not clinically new.
There are no wet shoes when walking along the river.
You will eventually encounter more punctures.
This article does not discuss the mechanism and treatment of PDPH (
