Abstract:
UNLABELLED:Epidural catheters (EC) are often used in pediatric patients for intraoperative and postoperative pain relief. The small anatomical structures and catheter insertion under general anesthesia make it more difficult to perform EC and to prevent damage. In this study we investigated the use of ultrasound (US) in detecting neuraxial structures during insertion and placement of EC in children. ASA I-II children scheduled for elective surgery under combined general and epidural anesthesia were studied. Patients received balanced anesthesia using sevoflurane, opioids and rocuronium. Before EC insertion US examination in a lateral position was done to visualize and identify neuraxial structures. Quality of visualization and site and depth of structures were recorded. Using a sterile kit to hold the US probe in position and enable the visualization of the neuraxial structures, an epidural cannula was inserted, using the loss of resistance technique, as the EC passed under US control to the desired level. Of 25 children, 23 were evaluated. Epidural space, ligamentum flavum, and dural structures were clearly identified and the depth to skin level estimated in all patients. Loss of resistance was visualized in all patients with a lumbar epidural approach. Correlation of US measured depth and depth of loss of resistance was 0.88. In eight of 23 patients EC could be visualized during insertion and in 11 others it could be visualized with additional US planes. US is an excellent tool to identify neuraxial structures in both infants and children. The size and the incomplete ossification of the vertebra allow exact visualization and localization of the depth of the epidural space, the loss of resistance, and all relevant neuraxial structures. IMPLICATIONS:Epidural catheters in children are mostly inserted under sedation or general anesthesia. This study showed that the use of ultrasound could help visualize all relevant neuraxial structures and their site and depth from the skin.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Rapp HJ,Folger A,Grau Tdoi
10.1213/01.ANE.0000156579.11254.D1subject
Has Abstractpub_date
2005-08-01 00:00:00pages
333-9, table of contentsissue
2eissn
0003-2999issn
1526-7598pii
101/2/333journal_volume
101pub_type
杂志文章abstract::Clonidine in spinal and epidural blocks prolongs anesthesia, but can cause hypotension and bradycardia. The aim of our study was to compare hemodynamic and analgesic effects of spinal versus epidural clonidine alone and after repetitive dosing. In a prospective, randomized, double-blind study, we evaluated 40 patients...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199502000-00020
更新日期:1995-02-01 00:00:00
abstract:IMPLICATIONS:Misplacement of an epidural catheter into the subarachnoid space is a recognized complication. However, breakage of an intrathecal epidural catheter during removal presents a dilemma. Appropriate imaging, a neurosurgical consultation, and aggressive surgical exploration and extraction of the retained piece...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200210000-00055
更新日期:2002-10-01 00:00:00
abstract::The nasal route is preferred for fiberoptic intubation. Placing a lubricated endotracheal tube through the nostril can guide the fiberoptic scope towards the larynx. It would be helpful for optimal visualization of the vocal cord when the scope is passed through the endotracheal tube if the length of nares-vocal cord ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000149900.68354.33
更新日期:2005-05-01 00:00:00
abstract:UNLABELLED:Using a randomized, double-blind protocol design, we compared a new lower-lipid emulsion of propofol (Ampofol) containing propofol 1%, soybean oil 5%, and egg lecithin 0.6% with the most commonly used formulation of propofol (Diprivan) with respect to onset of action and recovery profiles, as well as intraop...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ane.0000103184.36451.d7
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Postoperative nausea (PON) is a common complication of anesthesia and surgery. Antiemetic medication for higher-risk patients may reduce but does not reliably prevent PON. We examined aromatherapy as a treatment for patients experiencing PON after ambulatory surgery. Our primary hypothesis was that in compar...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e31824a0b1c
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:The diagnosis of postoperative cognitive dysfunction (POCD) requires complicated neuropsychological testing and is often delayed. Possible biomarkers for early detection or prediction are essential for the prevention and treatment of POCD. Preoperative screening of salivary cortisol levels may help to identi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003740
更新日期:2019-02-01 00:00:00
abstract::Twenty-four male patients scheduled for elective pulmonary resection were studied to determine whether continuous insufflation of oxygen to the nonventilated lung would reduce intrapulmonary shunting (Qs/Qt) and arterial oxygen desaturation. Measurements of physiologic variables were made using pulmonary arterial and ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract::This study investigated the use of propofol in swine genetically susceptible to malignant hyperthermia (MH). Thirteen animals were exposed to 2% halothane in inspired air, a propofol infusion of 12 mg.kg-1.hr-1 for up to 45 min, or a combination of both. When MH was triggered the animals were treated with dantrolene. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract:UNLABELLED:The dose-response curve for the effect of volatile anesthetics on the somatosensory evoked potential (SEP) is well described, but for propofol, the large dose segment of the curve is undefined. We describe the effect of increasing plasma concentrations of propofol on cortical SEPs in 18 rats. After surgical ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000090318.16879.a8
更新日期:2003-12-01 00:00:00
abstract::Health care-associated infections are a hospital-wide concern associated with a significant increase in patient morbidity, mortality, and health care costs. Bacterial transmission in the anesthesia work area of the operating room environment is a root cause of 30-day postoperative infections affecting as many as 16% o...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000505
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:The infraclavicular approach to the brachial plexus provides suitable anesthesia and also lends itself well to stabilizing and securing a catheter for a continuous infusion. We describe an approach for continuous infusions using an infraclavicular approach in children. METHODS:Twenty-five patients aged 8 ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000289633.81407.65
更新日期:2008-01-01 00:00:00
abstract::The anesthetic propofol (2,6 diisopropylphenol) mediates some of its effects by activating inhibitory chloride currents in the lower brainstem and spinal cord. The effects comprise direct activation of gamma-aminobutyric acid-A and glycine receptors in the absence of the natural agonist, as well as potentiation of the...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000120083.10269.54
更新日期:2004-07-01 00:00:00
abstract:UNLABELLED:Intraoperative transesophageal echocardiography (TEE) is frequently used in children with congenital heart disease (CHD). Although transnasal TEE is being used in various settings in the adult population, there are no descriptions of its use intraoperatively in patients with CHD. This report describes the su...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000086729.89284.45
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:IV infusion systems can be configured with manifolds connecting multiple drug infusion lines to transcutaneous catheters. Prior in vitro studies suggest that there may be significant lag times for drug delivery to reflect changes in infusion rates set at the pump, especially with low drug and carrier flows a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182a76f3b
更新日期:2013-12-01 00:00:00
abstract:UNLABELLED:We evaluated the effects of aggressive warming and maintenance of normothermia on surgical blood loss and allogeneic transfusion requirement. We randomly assigned 150 patients undergoing total hip arthroplasty with spinal anesthesia to aggressive warming (to maintain a tympanic membrane temperature of 36.5 d...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200010000-00039
更新日期:2000-10-01 00:00:00
abstract:UNLABELLED:A cohort of seven patients receiving intrathecal analgesic drug therapy for chronic intractable pain underwent radiocontrast myelography and computed tomography (CT) scanning to screen for catheter-associated intrathecal masses. Three of seven patients examined had intraspinal masses associated with the tip ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200301000-00039
更新日期:2003-01-01 00:00:00
abstract:UNLABELLED:Linking physiological pharmacokinetic models to models of the cardiovascular system requires knowledge of the sites in the body that mediate a drug's cardiovascular effects. We examined the role of the coronary concentrations of propofol. Nine sheep anesthetized with isoflurane (2%) were instrumented acutely...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000060561.16583.a7
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Postpartum depression is a common psychiatric disorder in parturients after delivery. The etiology remains unclear, and multiple factors may be involved. In this study, we investigated whether epidural labor analgesia was associated with a decreased risk of postpartum depression development. METHODS:Two hun...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000107
更新日期:2014-08-01 00:00:00
abstract:UNLABELLED:We conducted this retrospective study to document the efficacy and safety, and demonstrate the spectrum of indications for subcutaneously tunneled epidural catheters in the management of prolonged pain in pediatric patients. The charts of 25 patients with prolonged pain that was unresponsive to conventional ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200106000-00016
更新日期:2001-06-01 00:00:00
abstract:UNLABELLED:To determine whether a weight-related dose had advantages over a fixed, large-dose regimen, we measured plasma concentrations of aprotinin by using an enzyme-linked immunosorbent assay method at set time points in 30 patients having heart surgery with cardiopulmonary bypass. A weight-related dose comprising ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200104000-00007
更新日期:2001-04-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199910000-00013
更新日期:1999-10-01 00:00:00
abstract:UNLABELLED:A 3-yr-old with B-cell lymphoma presented with a 5-wk history of 400 mL/day cerebrospinal fluid (CSF) leak, which precluded chemotherapy, after placement of an Omaya reservoir and drain. Surgical repair was unsuccessful. Symptoms included irritability, failure to eat and noncommunication. After lumbar epidur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000100661.31566.43
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:There are profound racial and ethnic disparities in obstetric outcomes in the United States, but little is known about disparities in risk of postpartum hemorrhage (PPH). We explored the association of race and ethnicity on the risk of PPH due to uterine atony with sequential adjustment for possible mediatin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182691e62
更新日期:2012-11-01 00:00:00
abstract::The purpose of this study was to measure and compare the relationship of cardiovascular depression and dose during equal potent levels of halothane and isoflurane anesthesia in neonates (n = 19) (16.7 +/- 6.9 days) and infants (n = 54) (6.1 +/- 3.1 mo). Seventy-three children had heart rate, arterial blood pressure, a...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199203000-00003
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Perioperative opioid use is associated with poor survival in patients with esophageal squamous cell carcinoma. The most common histological type of esophageal cancer in western countries is adenocarcinoma. The objective of this study was to evaluate the association between intraoperative opioid consumption a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003428
更新日期:2018-07-01 00:00:00
abstract::To determine the effect of liver disease on the pharmacokinetics of rocuronium, the authors administered 0.6 mg/kg (twice the ED95) to 10 patients with liver disease and compared these results to values in 10 healthy surgical patients. Anesthesia was induced with thiopental and maintained with isoflurane (0.9%-1.1% en...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199504000-00018
更新日期:1995-04-01 00:00:00
abstract::Neurologic complications accompanying spinal anesthesia were examined in 576 lumbar disc operations on 507 patients. The single serious complication did not seem attributable to the choice of anesthetic method. Minor neurologic complications, with the exception of spinal headache, could be explained by surgical manipu...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197607000-00022
更新日期:1976-07-01 00:00:00
abstract::A recognized side effect of chemonucleolysis is life-threatening anaphylaxis to chymopapain. In the clinical trials of chymopapain, 13 cases of anaphylaxis were reported in 1585 administrations (0.82%). Two patients died. Data from a postmarketing survey (48,239 questionnaires) were reviewed to identify factors influe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197711000-00019
更新日期:1977-11-01 00:00:00
abstract:IMPLICATIONS:We describe a technique of one-lung high-frequency jet ventilation surgery with continuous monitoring of airway pressures that achieves satisfactory operating conditions with less complications than other similar approaches. ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200301000-00059
更新日期:2003-01-01 00:00:00