Epidural anesthesia prevents hypercoagulation in patients undergoing major orthopedic surgery.

Abstract:

BACKGROUND AND OBJECTIVES:Epidural anesthesia (EA) is known to reduce postoperative thromboembolic complications, but mechanisms are incompletely understood. In this study, we tested the hypothesis that local anesthetics (LA) prevent postoperative hypercoagulability without affecting physiologic aggregation and coagulation processes. METHODS:Clot signature analysis (CSA) was used to assess platelet and clotting function. Venous blood samples were collected pre- and postoperatively from 41 patients undergoing major orthopedic surgery. The effect of surgery on 3 CSA parameters (platelet-mediated hemostasis time [PHT], clotting time [CT], and collagen-induced thrombus formation [CITF]) was determined in patients receiving EA (n = 20) and those receiving general anesthesia (GA) (n = 21). RESULTS:In the GA group, orthopedic surgery induced a hypercoagulable state: PHT was reduced by 39% +/- 8.6% (P <.001), CT by 21% +/- 3.3% (P <.001), CITF by 10.3% +/- 5.9% (P =.06) compared with respective baseline values. In the EA group, by contrast, no parameter was altered significantly, but PHT showed a tendency towards prolongation by 33.2% +/- 15.4% (P =.25). CT changed by 0% +/- 4.4% (P =.89), CITF by 3.8% +/- 7% (P =.78). CONCLUSIONS:Use of EA prevents immediate postoperative hypercoagulability without affecting physiologic aggregation and coagulation processes. Also, CSA appears useful in predicting hypercoagulability and detecting platelet dysfunction. Reg Anesth Pain Med 2001;26:215-222.

journal_name

Reg Anesth Pain Med

authors

Hollmann MW,Wieczorek KS,Smart M,Durieux ME

doi

10.1053/rapm.2001.23209

subject

Has Abstract

pub_date

2001-05-01 00:00:00

pages

215-22

issue

3

eissn

1098-7339

issn

1532-8651

pii

S1098-7339(01)93204-3

journal_volume

26

pub_type

杂志文章
  • Evaluation of efficacy and plasma concentrations of ropivacaine in continuous axillary brachial plexus block: high dose for surgical anesthesia and low dose for postoperative analgesia.

    abstract:BACKGROUND AND OBJECTIVES:Ropivacaine is a potent local anesthetic that, experimentally at low concentrations, produces an effective block of pain conducting nerve fibers. Therefore, it was hypothesized that 0.1% and 0.2% ropivacaine would provide clinically adequate postoperative analgesia in continuous axillary plexu...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s1098-7339(00)80010-3

    authors: Salonen MH,Haasio J,Bachmann M,Xu M,Rosenberg PH

    更新日期:2000-01-01 00:00:00

  • Ultrasound-guided sciatic nerve block in overweight and obese patients: a randomized comparison of performance time between the infragluteal and subgluteal space techniques.

    abstract:BACKGROUND AND OBJECTIVES:Despite ultrasound (US) guidance, sciatic nerve block (SNB) remains among the least performed peripheral blocks. By targeting the tissue plane between the gluteus maximus and quadratus femoris muscles, the US-guided subgluteal space technique may facilitate the performance of US-guided SNB. We...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/AAP.0000000000000016

    authors: Abdallah FW,Chan VW,Koshkin A,Abbas S,Brull R

    更新日期:2013-11-01 00:00:00

  • Effect of Topical Morphine on Acute and Chronic Postmastectomy Pain: What Is the Optimum Dose?

    abstract:BACKGROUND AND OBJECTIVES:Poorly controlled postoperative pain is strongly associated with the development of chronic pain. We aimed to investigate the effect of topical morphine (in 1 of 3 doses: 5, 10, or 15 mg) on acute and chronic neuropathic pain after modified radical mastectomy for cancer breast. METHODS:In thi...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/AAP.0000000000000496

    authors: Mohamed SA,Abdel-Ghaffar HS,Kamal SM,Fares KM,Hamza HM

    更新日期:2016-11-01 00:00:00

  • Long-term pain, stiffness, and functional disability after total knee arthroplasty with and without an extended ambulatory continuous femoral nerve block: a prospective, 1-year follow-up of a multicenter, randomized, triple-masked, placebo-controlled tria

    abstract:BACKGROUND:Previously, we have demonstrated that extending a continuous femoral nerve block (cFNB) from overnight to 4 days after total knee arthroplasty (TKA) provides clear benefits during the infusion, but not subsequent to catheter removal. However, there were major limitations in generalizing the results of that i...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/aap.0b013e3182052505

    authors: Ilfeld BM,Shuster JJ,Theriaque DW,Mariano ER,Girard PJ,Loland VJ,Meyer S,Donovan JF,Pugh GA,Le LT,Sessler DI,Ball ST

    更新日期:2011-03-01 00:00:00

  • Spinal anesthesia for orthopedic surgery: a detailed video assessment of quality.

    abstract:BACKGROUND:Subarachnoid blocks are considered routine anesthetic procedures important in the daily practices of most anesthesiologists. However, few data exist regarding modern failure rates or quality-compromising behaviors. METHODS:Sixty adult patients having orthopedic surgery under spinal anesthesia were enrolled ...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0b013e3182030863

    authors: Weed J,Finkel K,Beach ML,Granger CB,Gallagher JD,Sites BD

    更新日期:2011-01-01 00:00:00

  • A case report of reappearance of spinal anesthesia.

    abstract:OBJECTIVE:We present a case of reappearance of spinal anesthesia despite the use of plain (isobaric) lidocaine and without an associated cough or Valsalva maneuver. CASE REPORT:A 66-year-old man had spinal anesthesia for knee arthroscopy. Two hours after the induction of spinal anesthesia and after the patient's motor...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1016/j.rapm.2007.11.007

    authors: Deleon AM,Benzon HT,Eisenman TS,Doty RA Jr,Newell B,McLaughlin K

    更新日期:2008-05-01 00:00:00

  • Comparison of bupivacaine, ropivacaine, and levobupivacaine in an equal dose and concentration for sympathetic block in dogs.

    abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to compare the potency of bupivacaine, ropivacaine, and levobupivacaine in an equal dose and concentration for sympathetic block. METHODS:We measured mean arterial pressure, heart rate (HR), and right and left brachial artery blood flow (BABF) before and after cervic...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0b013e3181e6acf1

    authors: Hashimoto T,Iwasaki T,Takahashi Y,Kimura Y,Nagao M,Yamaguchi S,Hamaguchi S,Kitajima T

    更新日期:2010-09-01 00:00:00

  • Progression of forearm intravenous regional anesthesia with ropivacaine.

    abstract::The progression of sensory blockade in the hand following a forearm Bier block with ropivacaine is currently unknown. The hands of 10 healthy adult human subjects were anesthetized with ropivacaine, and their sensitivities to cold and touch were tested until the completion of anesthesia. On average, insensitivity to c...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0b013e31820d42ed

    authors: Horn JL,Cordo P,Künster D,Harvey C,Cherry A,Bratt A,Gurfinkel V

    更新日期:2011-03-01 00:00:00

  • Serum ropivacaine levels after local infiltration analgesia during total knee arthroplasty with and without adductor canal block.

    abstract:BACKGROUND AND OBJECTIVES:A common analgesic technique for total knee arthroplasty (TKA) is to inject local anesthetic into the periarticular tissue during surgery, known as local infiltration analgesia (LIA). Since the solution used typically contains a large amount of local anesthetic, concerns arise about exceeding ...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1136/rapm-2018-100043

    authors: Koniuch KL,Buys MJ,Campbell B,Gililland JM,Pelt CE,Pace NL,Johnson KB

    更新日期:2019-01-11 00:00:00

  • Association of perioperative use of nonsteroidal anti-inflammatory drugs with postoperative myocardial infarction after total joint replacement.

    abstract:BACKGROUND AND OBJECTIVES:Use of nonsteroidal anti-inflammatory drug (NSAIDs) analgesics is controversial because of cardiovascular risk, but perioperative use may be advantageous for total joint replacement. Thus, we performed this single-center observational cohort study to determine any association between NSAID use...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0b013e31823354f5

    authors: Liu SS,Bae JJ,Bieltz M,Ma Y,Memtsoudis S

    更新日期:2012-01-01 00:00:00

  • Is circumferential injection advantageous for ultrasound-guided popliteal sciatic nerve block?: A proof-of-concept study.

    abstract:BACKGROUND:Ultrasound (US) guidance, in some instances, can increase the success rate and reduce the onset and procedure times for peripheral nerve blockade compared with traditional nerve localization techniques. The presumptive mechanism for these benefits is the ability to accurately inject local anesthetic circumfe...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/AAP.0b013e318217a6a1

    authors: Brull R,Macfarlane AJ,Parrington SJ,Koshkin A,Chan VW

    更新日期:2011-05-01 00:00:00

  • Ganglionic local opioid application (GLOA) for treatment of chronic headache and facial pain.

    abstract:OBJECTIVE:This report describes the effects of ganglionic local opioid application (GLOA) in patients with chronic headache and persistent idiopathic facial pain. CASE REPORT:We present 2 patients with chronic headaches and 1 patient with persistent idiopathic facial pain who were refractory to medical treatment. Thes...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1016/j.rapm.2006.03.011

    authors: Harris CL,Hamid B,Rosenquist RW,Schultz-Stubner SH

    更新日期:2006-09-01 00:00:00

  • Management of a Ventral Cerebrospinal Fluid Leak With a Lumbar Transforaminal Epidural Blood Patch in a Child With Persistent Postdural Puncture Headache: A Case Report.

    abstract:OBJECTIVE:Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0000000000000562

    authors: Dʼsouza G,Seidel FG,Krane EJ

    更新日期:2017-03-01 00:00:00

  • The Use of Regional or Neuraxial Anesthesia for Below-Knee Amputations May Reduce the Need for Perioperative Blood Transfusions.

    abstract:BACKGROUND AND OBJECTIVES:Amputations of the lower extremity remain a common procedure in a high-risk population. Perioperative morbidity and mortality reach as high as 14.1% in below-knee amputations. We aimed to determine whether regional, or neuraxial, anesthesia, when compared with general anesthesia (GA), would be...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0000000000000687

    authors: Malik O,Brovman EY,Urman RD

    更新日期:2018-01-01 00:00:00

  • Epidural catheter placement in neonates: sonoanatomy and feasibility of ultrasonographic guidance in term and preterm neonates.

    abstract:BACKGROUND:We report the first prospective sonoanatomic study in neonates with the aim to perform ultrasonographic-guided epidural catheter placement in this age group. METHOD:One hundred forty-five neonates with a body weight < or =4 kg (0.53-4 kg) were included in this prospective study. The study was divided into 3...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1016/j.rapm.2006.10.008

    authors: Willschke H,Bosenberg A,Marhofer P,Willschke J,Schwindt J,Weintraud M,Kapral S,Kettner S

    更新日期:2007-01-01 00:00:00

  • Proactive error analysis of ultrasound-guided axillary brachial plexus block performance.

    abstract:BACKGROUND:Detailed description of the tasks anesthetists undertake during the performance of a complex procedure, such as ultrasound-guided peripheral nerve blockade, allows elements that are vulnerable to human error to be identified. We have applied 3 task analysis tools to one such procedure, namely, ultrasound-gui...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0b013e318228d1c0

    authors: O'Sullivan O,Aboulafia A,Iohom G,O'Donnell BD,Shorten GD

    更新日期:2011-09-01 00:00:00

  • A randomized comparison between ultrasound- and fluoroscopy-guided third occipital nerve block.

    abstract:BACKGROUND:Third occipital nerve block (TONB) is commonly used in the diagnosis and treatment of upper neck pain and cervicogenic headaches. Although fluoroscopy is the current imaging standard for TONB, ultrasound (US) guidance offers a promising, radiation-free alternative. In this randomized, observer-blinded trial,...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/AAP.0b013e31828b25bc

    authors: Finlayson RJ,Etheridge JP,Vieira L,Gupta G,Tran DQ

    更新日期:2013-05-01 00:00:00

  • Hydrodynamics of the spinal epidural space in pigs: effects of death and exsanguinations.

    abstract:BACKGROUND AND OBJECTIVES:We have investigated how the vascular components of the spine determine the resistance and capacitance of the spinal epidural space and determined the magnitude of the longitudinal pressure gradient in the space during fluid infusion. METHODS:Pigs were studied during isoflurane anesthesia. Tu...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0b013e3181958fad

    authors: Blix EU,Buffington CW

    更新日期:2009-03-01 00:00:00

  • Ultrasound-guided brachial plexus block in a patient with multiple glomangiomatosis.

    abstract:BACKGROUND AND OBJECTIVES:Glomangiomas are rare, vascular tumors consisting of an afferent artery, arteriovenous canal, neuro-reticular elements, collagen, and efferent veins, and are most often located in the soft tissue of the upper extremities. We describe how the use of ultrasound-guided nerve blockade altered the ...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1016/j.rapm.2007.10.003

    authors: Duggan E,Brull R,Lai J,Abbas S

    更新日期:2008-01-01 00:00:00

  • Unintentional subdural placement of epidural catheters during attempted epidural anesthesia: an anatomic study of spinal subdural compartment.

    abstract:BACKGROUND:Although infrequent, subdural block is a complication of epidural anesthesia with obvious implications. Knowledge of the spinal subdural compartment (dura-arachnoid interface) may help elucidate controversies arising from evidence that subdural catheter placement is feasible and may be difficult to identify ...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0b013e31822e0e8c

    authors: Reina MA,Collier CB,Prats-Galino A,Puigdellívol-Sánchez A,Machés F,De Andrés JA

    更新日期:2011-11-01 00:00:00

  • Early experience with continuous cervical paravertebral block using a stimulating catheter.

    abstract:BACKGROUND AND OBJECTIVES:This study reports our early experience with continuous cervical paravertebral block (CCPVB) using a stimulating catheter for the management of acute pain after shoulder surgery. METHODS:This prospective observational study presents 256 CCPVB for pain relief after 14 different shoulder operat...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 临床试验,杂志文章

    doi:10.1016/s1098-7339(03)00221-9

    authors: Boezaart AP,De Beer JF,Nell ML

    更新日期:2003-09-01 00:00:00

  • American Society of Regional Anesthesia and Pain Medicine Local Anesthetic Systemic Toxicity checklist: 2020 version.

    abstract::The American Society of Regional Anesthesia and Pain Medicine (ASRA) periodically updates its practice advisories and associated cognitive aids. The 2020 version of the ASRA Local Anesthetic Systemic Toxicity checklist was created in response to user feedback, simulation studies and advances in medical knowledge. This...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1136/rapm-2020-101986

    authors: Neal JM,Neal EJ,Weinberg GL

    更新日期:2021-01-01 00:00:00

  • Development and Validation of an Assessment of Regional Anesthesia Ultrasound Interpretation Skills.

    abstract:BACKGROUND:Interpretation of ultrasound images and knowledge of anatomy are essential skills for ultrasound-guided peripheral nerve blocks. Competency-based educational models promoted by the Accreditation Council for Graduate Medical Education require the development of assessment tools for the achievement of differen...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/AAP.0000000000000236

    authors: Woodworth GE,Carney PA,Cohen JM,Kopp SL,Vokach-Brodsky LE,Horn JL,Missair A,Banks SE,Dieckmann NF,Maniker RB

    更新日期:2015-07-01 00:00:00

  • Improving the therapeutic window of conventional opioids: novel differential signaling modulators.

    abstract::Conventional opioids are widely used for acute pain management in the postoperative setting. However, a primary concern with conventional opioids is their therapeutic window-the range between doses that produce the desired therapeutic effect (analgesia) and doses that produce unwanted opioid-related adverse events (OR...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章,评审

    doi:10.1136/rapm-2018-000010

    authors: Viscusi ER

    更新日期:2019-01-01 00:00:00

  • Doppler measurement of the changes of fetal umbilical and middle cerebral artery velocimetric indices during continuous epidural labor analgesia.

    abstract:OBJECTIVE:Although complications of the epidural technique are known to affect the fetus adversely, there are no data indicating that regional analgesia directly causes harmful effects to the fetus. Our purpose was to determine the effect of epidural labor analgesia on the Doppler velocimetric indices of the uterine an...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0b013e31820d4334

    authors: Chen LK,Yang YM,Yang YH,Lee CN,Chen SS,Sun WZ

    更新日期:2011-05-01 00:00:00

  • Accuracy and consistency of modern elastomeric pumps.

    abstract::Continuous peripheral nerve blockade has become a popular method of achieving postoperative analgesia for many surgical procedures. The safety and reliability of infusion pumps are dependent on their flow rate accuracy and consistency. Knowledge of pump rate profiles can help physicians determine which infusion pump i...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1097/AAP.0000000000000130

    authors: Weisman RS,Missair A,Pham P,Gutierrez JF,Gebhard RE

    更新日期:2014-09-01 00:00:00

  • Effect of systemic adenosine on pain and secondary hyperalgesia associated with the heat/capsaicin sensitization model in healthy volunteers.

    abstract:BACKGROUND AND OBJECTIVES:Adenosine is an endogenous compound that may have analgesic effects. Results from clinical trials are not consistent, however, and there is a need for large-scale, randomized, placebo-controlled studies to clarify the role of adenosine in the treatment of pain states, including acute nocicepti...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1053/rapm.2001.22256a

    authors: Dirks J,Petersen KL,Rowbotham MC,Dahl JB

    更新日期:2001-09-01 00:00:00

  • Acute cigarette smoking reduces vasodilative effect induced by sympathetic block in dogs.

    abstract:BACKGROUND AND OBJECTIVES:The aim of this study is to clarify the influence of acute cigarette smoking on vasodilation induced by sympathetic block. METHODS:We measured mean arterial pressure, heart rate, left brachial artery blood flow (BABF), right femoral artery blood flow (FABF), and plasma catecholamines in dogs ...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1053/rapm.2001.16163

    authors: Kitajima T,Okuda Y,Mishio M,Hamaguchi S,Yamaguchi S,Kimura Y

    更新日期:2001-01-01 00:00:00

  • Viscosupplementation: a new concept in the treatment of sacroiliac joint syndrome: a preliminary report of four cases.

    abstract:BACKGROUND AND OBJECTIVES:We describe a new therapeutic modality for sacroiliac joint syndrome that represents an alternative to other treatment modalities. We report on four cases of sacroiliac joint syndrome with severe pain. METHODS:Three patients had undergone operative treatment of the lumbar spine and one patien...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1016/s1098-7339(99)90170-0

    authors: Srejic U,Calvillo O,Kabakibou K

    更新日期:1999-01-01 00:00:00

  • Anterior quadratus lumborum block analgesia for total hip arthroplasty: a randomized, controlled study.

    abstract:BACKGROUND AND OBJECTIVES:Quadratus lumborum (QL) block is a new regional analgesic technique for upper and lower abdominal surgeries as part of a multimodal analgesic regime. It has also been reported to relieve pain after total hip arthroplasty (THA). In this prospective, randomized, double-blind study, we compared Q...

    journal_title:Regional anesthesia and pain medicine

    pub_type: 杂志文章

    doi:10.1136/rapm-2019-100804

    authors: Kukreja P,MacBeth L,Sturdivant A,Morgan CJ,Ghanem E,Kalagara H,Chan VWS

    更新日期:2019-10-25 00:00:00