EXPERIENCE OF USING NEEDLES WITH DIFFERENT TYPES OF TIPS FOR PERFORMING SPINAL AND EPIDURAL ANESTHESIA IN THE ENVIRONMENT OF THE PENINATAL CENTER OF THE CITY OF RYAZAN

Aim. The aim of the study was to increase the safety of epidural and spinal anesthesia, reduce the frequency, prevention of post-operative headache in women in labor. Materials and methods. The data of 180 women aged 19 to 42 years who underwent epidural or spinal anesthesia during the operation «fetal extraction from the uterine cavity» were analyzed. Parturient women were divided into 2 groups: 1 (60 women) used Quincke-type needles, 2 (120 women) performed anesthesia with Whitacar-type needles with «pencil-point» sharpening.The criterion for inclusion in the study was the absence of concomitant diseases and pathologies of pregnancy, except for the anatomical narrowness of the birth canal, making it impossible to deliver through the natural birth canal. Results. It was found that the use of needles with a Quincke type in 30% of cases there was a post-puncture headache. The mechanism of this complication we associate with the violation of the integrity of the dura mater. This leads to the expiration of liquor and reduce the pressure of cerebrospinal fluid. To reduce the negative effects of the proposed author's method of administration of colloidal and crystalloid drugs in combination with caffeine. Conclusions. To reduce complications during spinal and epidural anesthesia in obstetric practice it is preferable to use needles with sharpening of «pencil-point» type. In the case of postoperative complications in the form of violations of adaptive vasomotor reactions, it is recommended to use crystalloids and colloids in combination with caffeine by the author's method.