Method for novocaine block

FIELD: medicine.

SUBSTANCE: patient is laid on his/her side opposite a block region. A guide mark is a vertical line in a projection of Petit's triangle from the twelfth rib to a wing of ilium. A needle is pricked into the skin on the vertical line at 1.5-2.5cm above the wing of ilium. 0.25% Novocaine is administered in layers into the skin and subcutaneous fat. The needle is advanced into the lumbar region from back to front in the medial direction along the lateral edge of broadest muscle of back at 6-8cm. Novocaine 120ml is administered into the lower order of the lumboiliac fossa formed in this region.

EFFECT: effective and safe pain management in the given category of patients by providing the required Novocaine concentration in the retroperitoneal space.

1 dwg, 1 ex

 

The invention relates to medicine, namely to urology, may be used in the treatment of renal colic, orchiepididymitis.

Known perirenal novocaine blockade in renal colic, in which the patient lies on his side, under the lower back cushion, the bottom leg bent at the knee and hip joints, top - stretched along the body. Find muscle-costal angle (intersection XII ribs and long muscles of the back), from its summit on the bisector retreat 1-2 cm and produce vcol needle. The direction of the needle perpendicular to the skin surface (the needle is aimed at the navel of the patient). Symptom finding the needle in the perirenal tissue: when removing the syringe from the needle, the solution is not dripping from the pavilion, and when the breath is drawn inside. After getting into the perirenal tissue injected 60-100 ml of 0.25% solution of novocaine. It is possible to conduct unilateral perirenal blockade (renal colic), but is used more frequently bilateral (perform the described manipulation in series with two sides), (see Ostroverkhov, E., Bomas Y. M., A. lubotsky, D. N. Operative surgery and topographic anatomy. - 1996).

For reasons that impede the achievement of specified following technical result when using the known method is that often arise such threatening complications, such as entry of the needle into the kidney damage is the group of vessels of the kidneys, damage to the ascending or descending colon, nephrosclerosis.

The objective of the invention is to provide a method procaine blockade, providing technical result, which allows you to create the necessary concentration of novocaine in the retroperitoneal space, and also reduces the risk of iatrogenic complications.

The technical result is achieved in that way procaine blockade includes determining the point of puncture of the skin with a needle and introduction through it a 0.25% solution of novocaine.

The feature is that the patient is placed in the position lying on its side on the side opposite to the location of the blockade, as a landmark spend a vertical line in the projection Petitou triangle from the end of the twelfth rib to the wing of the Ilium, and then on the vertical line of retreat on 1.5-2.5 cm above the wing of the Ilium and implement vcol needles into the skin layers introduce a solution of novocaine into the skin and subcutaneous fat, advance the needle into the lumbar region from front to back medially on the lateral edge of the latissimus a length of 6-8 cm formed in this area of the lower edge of the lumbar-iliac fossa, which directly enter solution of novocaine in the amount of 120 ml

The invention is illustrated in the drawing, where

1 - ver italina line reference, held from the end of the twelfth rib to the wing of the Ilium,

2 - the wing of the Ilium,

3 - place vcol needle,

4 - lateral edge of the latissimus,

5 - the rear edge of the external oblique muscle of the abdomen.

The method is as follows.

The patient is placed in the position lying on its side on the side opposite to the location of the blockade. In the projection Petitou triangle as a guide spend a vertical line 1 from the end of the twelfth rib to the wing 2 of the Ilium. On this vertical line 1, departing at 1.5-2.5 cm above the wing 2 of the Ilium, exercise vcol 3 needles into the skin layers and impose a 0.25% solution of novocaine into the skin and subcutaneous fat. Advance the needle into the lumbar region from front to back medially the length of 6-8 cm and fall to the lateral edge 4 latissimus that forms in this area of the lower edge of the lumbar-iliac fossa. This site retroperitoneal space is the boundary between the lumbar region and the cavity of the pelvis. Directly in this space enter solution of novocaine in the amount of 120 ml

The way procaine blockade allows you to create the necessary concentration of novocaine in the retroperitoneal space for relief of pain and also reduces the risk of iatrogenic complications.

Clinches the second example.

Patient M., aged 47, backgrounds 9.06.2012, turned in the urology Department goose "Ulyanovsk regional clinical center of specialized medical assistance, Ulyanovsk" with complaints of pain in the right lumbar region with irradiation in naklonnoy region, frequent urination. History of kidney stones within 5 years. A standard medical examination. According to ultrasonographical study found paleoclimate right in the distal ureter calculus with a diameter of 4 mm, the Diagnosis of Urolithiasis. The stone in the lower third of the right ureter. Right-sided renal colic.

backgrounds 9.06.2012, the patient performed novocaine blockade. The patient in the supine position on the left side. S. Novocaini was introduced from the right side in the projection Petitou triangle. Drew the line reference from the end of the 12 ribs vertically to the wing of the Ilium, which, departing at 2 cm above the iliac wing bone pierced the skin and layers introduced S. Novocaini in the skin, subcutaneous fat, advancing the needle into the lumbar region in a length of 7 cm and getting to the lateral edge of m.iliopsoas, which forms in this area of the lower edge of the lumbar-iliac fossa. Directly in this space introduced S. Novocaini 0,25% 120 ml. Pain controlled completely. Given the small calculus and the possibility of selfreliance is positive citokines, patient recommendations, discharged for outpatient treatment.

On the 7th day of conservative therapy occurred spontaneous passage of ureteral stones. The patient is examined after 1 month, 6 months - condition is satisfactory, no complaints.

Thus, the proposed method allows to create the necessary concentration of novocaine in the retroperitoneal space for relief of pain and also reduces the risk of iatrogenic complications.

The way procaine blockade in renal colic or orchiepididymitis, including the defining of the skin puncture needle and the introduction through it a 0.25% solution of novocaine, wherein the patient is placed in the position lying on its side on the side opposite to the location of the blockade, as a landmark spend a vertical line in the projection Petitou triangle from the twelfth rib to the wing of the Ilium, and then on the vertical line of retreat on 1.5-2.5 cm above the wing of the Ilium and implement vcol needles into the skin layers introduce a solution of novocaine into the skin and subcutaneous fat, advance the needle into the lumbar region from front to back medially on the lateral edge of the latissimus a length of 6-8 cm formed in this area of the lower edge of the lumbar-iliac fossa, which directly enter the Rast is the PR of novocaine in the amount of 120 ml



 

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2 ex

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1 ex

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1 ex

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1 ex

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3 ex

FIELD: biotechnology.

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EFFECT: invention provides low toxicity of dosage form and high efficiency.

5 cl, 3 tbl, 1 ex

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