Multiple approaches, such as lateral, prone, and lithotomy have been described (Figure 9-4.5).3 The most frequently used approach is the prone position. The sacrococcygeal area is prepped and draped in a sterile manner. The entry site, just under the tip of the coccyx, is anesthetized with lidocaine 0.5% using a 25-gauge needle. A 22-gauge, 3.5-in spinal needle is bent into a C shape (commercial C shape 22-gauge, 3.5-in spinal needles are also available). At the site of entry, just under the coccyx, the needle is advanced in a semicircular manner under fluoroscopy (lateral view) until the top of the needle is just anterior to the sacrococ-
cygeal junction. After a negative blood aspiration, a radio-opaque dye is injected (1-2mL) and the spread is viewed both in AP and lateral views. There should be a smooth contrast of the dye in the retroperitoneum between the sacrococcygeal region and the rectal bubble. After a negative blood aspiration, a total of 12 to 15mL of bupivacaine
0.375. is injected with intermittent aspirations.
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Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.