Inflammation of the needle puncture area

The article was professionally consulted by Specialist Doctor II To Van Thai - Emergency Medicine Doctor - Emergency Resuscitation Department - Vinmec Hai Phong International General Hospital.

Anesthesia is a technique that uses local anesthetic to suppress pain sensation in the intended surgical area, usually applied for short surgeries (less than 2 hours). The patient will be fully awake during the surgery. However, during the anesthetic process, special care should be taken to avoid infection of the needle puncture site.

Anesthesia is an anesthetic method that has many advantages such as: the patient is awake during surgery, reducing postoperative pain, limiting complications and side effects of general anesthesia. There are two main types of neuraxial anesthesia: spinal anesthesia and epidural anesthesia.
1.1. Spinal Anesthesia Spinal anesthesia is a technique of injecting numbing medicine or pain reliever into the space between the arachnoid and soft membranes of the spine so that this area loses pain sensation and causes motor paralysis. The anesthetic effect is usually after 5 minutes.
Usually applied to lower extremity related trauma surgery (knee replacement, hip replacement ..), obstetric, urinary tract and genitourinary surgery.

1.2. Epidural Anesthesia An epidural is an anesthetic technique that uses a large needle (Tuohy needle) to access the epidural space (not into the CSF space). The doctor then saves a piece of wire (catheter) through which a continuous anesthetic can be administered for the purpose of pain relief during and after surgery.
The numbing effect will appear after about 15 minutes.
Often applied for lower limb surgery and especially to relieve pain for women during vaginal birth.
Currently, epidural anesthesia is being used more flexibly than spinal anesthesia, providing high pain relief after surgery, helping patients recover faster, reducing the rate of myocardial infarction, pulmonary complications After surgery, decreased activation of the coagulation system.

Anesthesia allergy. Inflammation of the anesthetic needle puncture site. Severe systemic infection. Patients who bleed easily or are taking anticoagulants. Epilepsy. Mental illness . Severe cardiovascular disease.

Needle puncture procedure under spinal anesthesia
The patient chooses a sitting or lying position. Determine the puncture site.

Use alcohol to disinfect the anesthetic site 2-3 times. Dry and cover with a sterile towel with holes on top. Inject the anesthetic into the syringe. Locate the correct anesthetic site, then insert the anesthetic needle. Withdraw the needle barrel, observe if the cerebrospinal fluid flows out, then slowly inject the spinal anesthetic into the patient. After the injection is complete, remove the needle and guide needle at the same time. Epidural needle puncture procedure
Spread a sterile pore towel over the area to be anesthetized. Identify mold and local anesthetic. Insert the Tuohy needle into the anesthetized position and perform the loss of resistance test. Thread the Catheter lead, pull out the Tuohy needle. Attach the connector and filter to the Catheter. Paste and fix the Catheter.

Both techniques of needle puncture must ensure absolute sterility, so all instruments need to be autoclaved before the procedure. Anesthesiologists must wash their hands with antibacterial soap, dry them, and then wear gloves, a hat, and a medical gown before administering anesthesia to the patient. Absolutely make sure to keep absolute sterility during the operation. However, in rare cases, inflammation of the needle puncture site can occur.

Common anesthetic complications are inflammation of the needle puncture site, which can lead to permanent nerve damage with meningitis, encephalitis, epidural abscess, spinal cord compression, and more. even death.
Some causes of infection with anaerobic bacteria, anaerobic gram-negative bacilli, staphylococcus aureus, streptococcus .... Therefore, when performing anesthetic techniques for patients, doctors and technicians Strict adherence to infection prevention measures is essential, especially for immunocompromised patients.
The patient also needs to coordinate with the doctor, if there are any abnormal signs (eg, inflammation of the needle puncture area), it is necessary to immediately notify the doctor for appropriate treatment.
Doctor Thai has more than 34 years of experience in the field of anesthesia - emergency resuscitation and is currently a doctor at the Emergency Department of Vinmec Hai Phong International Hospital.
To register for an examination at Vinmec International General Hospital, you can contact the nationwide Vinmec Health System Hotline, or register online HERE.