Abstract:
BACKGROUND:Lower thoracic epidural anaesthesia and analgesia (EDA) has gained increasing importance in perioperative pain therapy. The loss-of-resistance technique used to identify the epidural space is thought to rely on the penetration of the ligamentum flavum. Investigations at the cervical and lumbar regions have demonstrated that the ligamentum flavum frequently exhibits incomplete fusion at different vertebral levels. Therefore, the aim of this study was to directly investigate the incidence of lower thoracic ligamentum flavum midline gaps in embalmed cadavers. METHODS:Vertebral column specimens were obtained from 47 human cadavers. Ligamentum flavum midline gaps were recorded between the vertebral levels T6 and L1. RESULTS:The incidence of midline gaps/number of viable specimens at the following levels was: T6-7: 2/45 (4.4%), T7-8: 1/47 (2.1%), T8-9: 2/45 (4.4%), T9-10: 7/39 (17.9%), T10-11: 12/34 (35.2%), T11-12: 10/35 (28.5%), T12/L1: 6/38 (15.8%). CONCLUSIONS:In the present study we have determined the frequency of lower thoracic ligamentum flavum midline gaps. Gaps are less frequent than at cervical levels, but more frequent than at lumbar levels. Peak incidence was found in the region between T10 and T12. Using a strict midline approach, one cannot therefore rely on the ligamentum flavum to impede entering the epidural space in all patients.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Lirk P,Colvin J,Steger B,Colvin HP,Keller C,Rieder J,Kolbitsch C,Moriggl Bdoi
10.1093/bja/aei133subject
Has Abstractpub_date
2005-06-01 00:00:00pages
852-5issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)36044-0journal_volume
94pub_type
杂志文章,评审abstract:BACKGROUND:The aim of this study was to test if intraoperative administration of N(2)O during propofol-remifentanil anaesthesia prevented the onset of postoperative opioid-induced hyperalgesia (OIH). METHODS:Fifty adult ASA I-II patients undergoing elective open septorhinoplasty under general anaesthesia were studied....
journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章
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journal_title:British journal of anaesthesia
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-06-01 00:00:00
abstract::We have compared the postoperative morphine requirements and analgesic efficacy of four doses of i.m. ketorolac 30 mg administered 6-hourly with placebo in a double-blind study of patients undergoing major or minor orthopaedic surgery. During the 24-h postoperative study period which began at the end of surgery, patie...
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
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