The methodology of intraosseous blockades
Intraosseous blockade is carried out in the treatment room with all the rules of aseptic and antiseptic. For the blockade we use disposable spinal needle.
Intraosseous blockade is carried out according to the method developed by prof. E.L. Sokov (1985, 1996, 2002).
Determine the most painful bone protrusion, 0.5% lidocaine infiltration produced by layers of soft tissue anaesthesia of the skin to the periosteum. Then, through the intramuscular needle the intraosseous needle is inserted along with the stylet upto the periosteum, which is then inserted to a depth of 0.5-1.0 cm in the bone marrow. Stylet is removed from the needle, the needle is connected to a syringe with a drug mixture of 1% lidocaine and 2.4 mg of dexamethasone. About 4.2 ml of autologous bone marrow is aspirated into the syringe. Mixing the contents of the syringe and in approximately 20-30 seconds occurs haemolysis and the new mixture is introduced intraosseously.
In most patients during the first 15-60 seconds after the initiation of drug mixture into the bone marrow, there is the phenomenon of "recognizable pain."
For intraosseous blockade we use the mixture of lidocaine 1% - 8 ml, 1-2 mg of dexamethasone solution, autologous bone marrow - 2-3 ml.
A needle of 10 ml syringe with a drug preparations, was introduced into the bone marrow, aspiration was done without removing the needle, the syringe was stirred, then, the resultant mixture was introduced intraosseously.
With a history of intolerance or contraindication to the drug being used as a part of the blockade mixture then it is replaced by another group of drug.
Stages of intraosseous blockade
Antiseptic treatment of the skin
Conducting the infiltration anesthesia
Trepanation of bone
Carrying out aspiration
Introduction of drug mixtures intraosseously