A Secret of Safe and Certified Epidural Analgesia

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  • KOSAKA Yoshihiro
    Professor Emeritus of Shimane Medical University Director of Sapporo Central Pain Clinic

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  • 安全・確実な硬膜外麻酔の秘訣

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  A secret of safe and certified epidural analgesia is to know the complications related to its procedures. You have to insert a needle and catheter into the epidural space certainly and inject adequate local anesthetics skillfully. After the block takes effect, you cannot leave the patient, and must monitor him or her for a while.<br>  The certification of the epidural space is unreliable, except for the hanging-drop method, and you need a closed observation for a out-patients.<br>  For cases of epidural analgesia with general anesthesia, you have to perform epidural analgesia under awake conditions, and you may introduce general anesthesia after a test block. When you neglect to perform a test block, you have to handle the situation as you would intrathecal spinal analgesia.

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