Does the investing layer of the deep cervical fascia exist?

Abstract:

BACKGROUND:The placement of the superficial cervical plexus block has been the subject of controversy. Although the investing cervical fascia has been considered as an impenetrable barrier, clinically, the placement of the block deep or superficial to the fascia provides the same effective anesthesia. The underlying mechanism is unclear. The aim of this study was to investigate the three-dimensional organization of connective tissues in the anterior region of the neck. METHODS:Using a combination of dissection, E12 sheet plastination, and confocal microscopy, fascial structures in the anterior cervical triangle were examined in 10 adult human cadavers. RESULTS:In the upper cervical region, the fascia of strap muscles in the middle and the fasciae of the submandibular glands on both sides formed a dumbbell-like fascia sheet that had free lateral margins and did not continue with the sternocleidomastoid fascia. In the lower cervical region, no single connective tissue sheet extended directly between the sternocleidomastoid muscles. The fascial structure deep to platysma in the anterior cervical triangle comprised the strap fascia. CONCLUSIONS:This study provides anatomical evidence to indicate that the so-called investing cervical fascia does not exist in the anterior triangle of the neck. Taking the previous reports together, the authors' findings strongly suggest that deep potential spaces in the neck are directly continuous with the subcutaneous tissue.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Nash L,Nicholson HD,Zhang M

doi

10.1097/00000542-200511000-00010

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

962-8

issue

5

eissn

0003-3022

issn

1528-1175

pii

00000542-200511000-00010

journal_volume

103

pub_type

杂志文章
  • I653 and isoflurane produce similar dose-related changes in the electroencephalogram of pigs.

    abstract::I653 is a new volatile anesthetic structurally similar to enflurane and isoflurane. Since enflurane can induce convulsions, whereas isoflurane progressively depresses cortical electrical activity, the authors believed it important to assess the effect of I653 on the EEG (in both the "time" and "frequency" domain). The...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198809000-00002

    authors: Rampil IJ,Weiskopf RB,Brown JG,Eger EI 2nd,Johnson BH,Holmes MA,Donegan JH

    更新日期:1988-09-01 00:00:00

  • A comparison of the effects of halothane and tetrodotoxin on the regional repolarization characteristics of canine Purkinje fibers.

    abstract::The effects of halothane, tetrodotoxin (TTX), veratridine (VTD), and alterations of extracellular calcium ion concentration [Ca++]0) on regional differences of canine Purkinje fiber action potential duration (APD50 and APD90) were investigated in vitro at a paced rate of 75 beats per min. Under control conditions (n =...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199012000-00014

    authors: Turner LA,Marijic J,Kampine JP,Bosnjak ZJ

    更新日期:1990-12-01 00:00:00

  • Effects of volatile anesthetics on acetylcholine-induced relaxation in the rabbit mesenteric resistance artery.

    abstract:BACKGROUND:Vascular endothelium plays an important role in the regulation of vascular tone. Volatile anesthetics have been shown to attenuate endothelium-mediated relaxation in conductance arteries, such as aorta. However, significant differences in volatile anesthetic pharmacology between these large vessels and the s...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199501000-00024

    authors: Akata T,Nakashima M,Kodama K,Boyle WA 3rd,Takahashi S

    更新日期:1995-01-01 00:00:00

  • Neuroprotective effects of riluzole and ketamine during transient spinal cord ischemia in the rabbit.

    abstract:BACKGROUND:Massive release of central excitatory neurotransmitters is an important initial step in ischemic neuronal injury, and modification of this process may provide neuroprotection. We studied the protective effects of the voltage-dependent sodium channel antagonist riluzole and the N-methyl-d-aspartate receptor a...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200011000-00025

    authors: Lips J,de Haan P,Bodewits P,Vanicky I,Dzoljic M,Jacobs MJ,Kalkman CJ

    更新日期:2000-11-01 00:00:00

  • Perioperative systemic magnesium to minimize postoperative pain: a meta-analysis of randomized controlled trials.

    abstract:BACKGROUND:Systemic magnesium has been used to minimize postoperative pain with conflicting results by clinical studies. It remains unknown whether the administration of perioperative systemic magnesium can minimize postoperative pain. The objective of the current investigation was to evaluate the effect of systemic ma...

    journal_title:Anesthesiology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/ALN.0b013e318297630d

    authors: De Oliveira GS Jr,Castro-Alves LJ,Khan JH,McCarthy RJ

    更新日期:2013-07-01 00:00:00

  • Isoflurane provides long-term protection against focal cerebral ischemia in the rat.

    abstract:BACKGROUND:Long-term neuroprotection by isoflurane has been questioned. The authors examined factors in experimental models potentially critical to definition of enduring isoflurane neuroprotection. METHODS:Rats were prepared for temporary middle cerebral artery occlusion (MCAO). Pericranial normothermia was maintaine...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200701000-00017

    authors: Sakai H,Sheng H,Yates RB,Ishida K,Pearlstein RD,Warner DS

    更新日期:2007-01-01 00:00:00

  • Glycine transporter inhibitors as a potential therapeutic strategy for chronic pain with memory impairment.

    abstract:BACKGROUND:Impaired excitatory and inhibitory balance in the spinal dorsal horn has a crucial role in the pathophysiology of chronic pain. The authors addressed the therapeutic impact of increasing spinal glycine applied exogenously or via blockade of glycine transporter 1 using its selective inhibitors sarcosine and N...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31816c9044

    authors: Tanabe M,Takasu K,Yamaguchi S,Kodama D,Ono H

    更新日期:2008-05-01 00:00:00

  • Functional magnetic resonance imaging studies of pain: an investigation of signal decay during and across sessions.

    abstract:BACKGROUND:Several investigations into brain activation caused by pain have suggested that the multiple painful stimulations used in typical block designs may cause attenuation over time of the signal within activated areas. The effect this may have on pain investigations using multiple tasks has not been investigated....

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200410000-00022

    authors: Ibinson JW,Small RH,Algaze A,Roberts CJ,Clark DL,Schmalbrock P

    更新日期:2004-10-01 00:00:00

  • Needle bevel direction and headache after inadvertent dural puncture.

    abstract::To study the effect of needle bevel direction on the incidence and severity of headache following inadvertent dural puncture occurring during the identification of the epidural space, the authors randomly assigned obstetric anesthesia residents to identify epidural space with the bevel of the epidural needle oriented ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-198905000-00002

    authors: Norris MC,Leighton BL,DeSimone CA

    更新日期:1989-05-01 00:00:00

  • Effects of intrathecally administered lamotrigine, a glutamate release inhibitor, on short- and long-term models of hyperalgesia in rats.

    abstract:BACKGROUND:Lamotrigine is a sodium channel blocker that inhibits the neuronal release of glutamate. Systemic administration of lamotrigine induces analgesia in short- and long-term models of hyperalgesia in rats. Considering the key role of N-methyl-D-aspartate receptors in the sensitization of dorsal horn neurons that...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199802000-00028

    authors: Klamt JG

    更新日期:1998-02-01 00:00:00

  • Comparative effects of propofol and halothane on outcome from temporary middle cerebral artery occlusion in the rat.

    abstract::Because propofol has cerebral effects similar to those observed for barbiturates, we postulated that it too might offer protection against a focal cerebral ischemic insult. Spontaneously hypertensive male rats were anesthetized with halothane (in 50% O2/balance N2), and their tracheas were intubated and their lungs me...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199205000-00020

    authors: Ridenour TR,Warner DS,Todd MM,Gionet TX

    更新日期:1992-05-01 00:00:00

  • Phenylephrine added to prophylactic ephedrine infusion during spinal anesthesia for elective cesarean section.

    abstract:BACKGROUND:Because ephedrine infusion (2 mg/min) does not adequately prevent spinal hypotension during cesarean delivery, the authors investigated whether adding phenylephrine would improve its efficacy. METHODS:Thirty-nine parturients with American Society of Anesthesiologists physical status I-II who were scheduled ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200109000-00020

    authors: Mercier FJ,Riley ET,Frederickson WL,Roger-Christoph S,Benhamou D,Cohen SE

    更新日期:2001-09-01 00:00:00

  • Initial Experience of an Anesthesiology-based Service for Perioperative Management of Pacemakers and Implantable Cardioverter Defibrillators.

    abstract:BACKGROUND:Management of cardiovascular implantable electronic devices (CIEDs), including pacemakers and implantable cardioverter defibrillators, for surgical procedures is challenging due to the increasing number of patients with CIEDs and limited availability of trained providers. At the authors' institution, a small...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000838

    authors: Rooke GA,Lombaard SA,Van Norman GA,Dziersk J,Natrajan KM,Larson LW,Poole JE

    更新日期:2015-11-01 00:00:00

  • Effect of renal failure and cirrhosis on the pharmacokinetics and neuromuscular effects of rapacuronium administered by bolus followed by infusion.

    abstract:BACKGROUND:Recent trials indicate that rapacuronium's pharmacokinetic characteristics are influenced by both renal failure and cirrhosis but the time course of a single bolus dose of 1.5 mg/kg is affected minimally. The authors reassessed these pharmacokinetic findings and examined the time course of the same bolus dos...

    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00000542-200012000-00007

    authors: Fisher DM,Dempsey GA,Atherton DP,Brown R,Abengochea A,Hunter JM

    更新日期:2000-12-01 00:00:00

  • Intrathecal coadministration of D-APV and morphine is maximally effective in a rat experimental pancreatitis model.

    abstract:BACKGROUND:Many studies have demonstrated that either glutamate -methyl-d-aspartate (NMDA) receptor antagonists or opioid receptor agonists provide antinociception. Spinal coadministration of an NMDA receptor antagonist and morphine has an additive action for control of various pain states in animal models. The current...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200303000-00024

    authors: Lu Y,Vera-Portocarrero LP,Westlund KN

    更新日期:2003-03-01 00:00:00

  • Malignant hyperthermia.

    abstract::In MH, skeletal muscle acutely and unexpectedly increases its oxygen consumption and lactate production, resulting in greater heat production, respiratory and metabolic acidosis, muscle ridigity, sympathetic stimulation, and increased cellular permeability. The best-accepted theory is that MH is due to an inability to...

    journal_title:Anesthesiology

    pub_type: 杂志文章,评审

    doi:10.1097/00000542-198011000-00007

    authors: Gronert GA

    更新日期:1980-11-01 00:00:00

  • Differential effects of lidocaine and mexiletine on relaxations to ATP-sensitive K+ channel openers in rat aortas.

    abstract:BACKGROUND:In cardiac myocytes, lidocaine reduces but mexiletine increases adenosine triphosphate (ATP)-sensitive K+ currents, suggesting that these class Ib antiarrhythmic drugs may differentially modify the activity of ATP-sensitive K+ channels. The effects of lidocaine and mexiletine on arterial relaxations induced ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199904000-00032

    authors: Kinoshita H,Ishikawa T,Hatano Y

    更新日期:1999-04-01 00:00:00

  • Combination of a δ-opioid Receptor Agonist and Loperamide Produces Peripherally-mediated Analgesic Synergy in Mice.

    abstract:BACKGROUND:The long-term use of opioids for analgesia carries significant risk for tolerance, addiction, and diversion. These adverse effects are largely mediated by μ-opioid receptors in the central nervous system. Based on the authors' previous observation that morphine and δ-opioid receptor agonists synergize in spi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002840

    authors: Bruce DJ,Peterson CD,Kitto KF,Akgün E,Lazzaroni S,Portoghese PS,Fairbanks CA,Wilcox GL

    更新日期:2019-09-01 00:00:00

  • Effects of volatile and intravenous anesthesia on the alveolar and systemic inflammatory response in thoracic surgical patients.

    abstract:BACKGROUND:One-lung ventilation (OLV) results in alveolar proinflammatory effects, whereas their extent may depend on administration of anesthetic drugs. The current study evaluates the effects of different volatile anesthetics compared with an intravenous anesthetic and the relationship between pulmonary and systemic ...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0b013e318214b9de

    authors: Schilling T,Kozian A,Senturk M,Huth C,Reinhold A,Hedenstierna G,Hachenberg T

    更新日期:2011-07-01 00:00:00

  • Lack of analgesic activity of morphine-6-glucuronide after short-term intravenous administration in healthy volunteers.

    abstract:BACKGROUND:The analgesic activity of morphine-6-glucuronide (M-6-G) is well recognized for its contribution to the effects of morphine and its possible use as an opioid analgesic with a wider therapeutic range than morphine. The present study attempted to quantify the relative contribution of M-6-G to analgesia observe...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199712000-00014

    authors: Lötsch J,Kobal G,Stockmann A,Brune K,Geisslinger G

    更新日期:1997-12-01 00:00:00

  • Inhalation anesthetics inhibit the release of endothelium-derived hyperpolarizing factor in the rabbit carotid artery.

    abstract:BACKGROUND:Inhalation anesthetics may interfere with the synthesis or action of endothelium-derived vasoactive factors. We investigated the effects of desflurane, enflurane, halothane, isoflurane, and sevoflurane on the release of nitric oxide and endothelium-derived hyperpolarizing factor (EDHF) in the isolated endoth...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199509000-00017

    authors: Lischke V,Busse R,Hecker M

    更新日期:1995-09-01 00:00:00

  • Tissue factor and platelet glycoprotein Ib-alpha alleles are associated with age at first coronary bypass operation.

    abstract:BACKGROUND:Age is a known risk factor for postoperative complications, but the genetic factors that account for variability in age at presentation for surgery have not been characterized. Because thrombosis is a critical process in the development of coronary syndromes, the authors hypothesized that patients bearing th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200312000-00009

    authors: Donahue BS,Byrne DW,Gailani D,George AL Jr

    更新日期:2003-12-01 00:00:00

  • Dose-response and plasma concentration-response relationships of pancuronium in man.

    abstract::The dose-response and plasma concentration-response relationships for pancuronium in man were studied during its intravenous administration to eight patients at a rate of 1.62 microgram/kg/min. The (log) dose-response relationships resulted in a sigmoid curve that was linear in its central range. At 20, 50 and 80 per ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197908000-00004

    authors: Shanks CA,Somogyi AA,Triggs EJ

    更新日期:1979-08-01 00:00:00

  • Signaling pathways involved in desflurane-induced postconditioning in human atrial myocardium in vitro.

    abstract:BACKGROUND:Isoflurane and sevoflurane have been shown to elicit myocardial postconditioning, but the effect of desflurane remain unknown. The authors studied the mechanisms involved in desflurane-induced myocardial postconditioning. METHODS:Contracting isolated human right atrial trabeculae (34 degrees C, stimulation ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31818d6b09

    authors: Lemoine S,Beauchef G,Zhu L,Renard E,Lepage O,Massetti M,Khayat A,Galera P,Gérard JL,Hanouz JL

    更新日期:2008-12-01 00:00:00

  • Effects of halothane and isoflurane on hyperexcitability of spinal dorsal horn neurons after incision in the rat.

    abstract:BACKGROUND:The aim of this study was to determine whether halothane and isoflurane used during and after surgical injury attenuate subsequent hyperexcitability of spinal dorsal horn (SDH) neurons by preventing development of central sensitization. METHODS:Activity of a wide-dynamic-range neuron of the SDH was isolated...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200501000-00025

    authors: Kawamata M,Narimatsu E,Kozuka Y,Takahashi T,Sugino S,Niiya T,Namiki A

    更新日期:2005-01-01 00:00:00

  • Positional Therapy and Regional Pulmonary Ventilation.

    abstract:BACKGROUND:Prone ventilation redistributes lung inflation along the gravitational axis; however, localized, nongravitational effects of body position are less well characterized. The authors hypothesize that positional inflation improvements follow both gravitational and nongravitational distributions. This study is a ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000003509

    authors: Xin Y,Cereda M,Hamedani H,Martin KT,Tustison NJ,Pourfathi M,Kadlecek S,Siddiqui S,Amzajerdian F,Connell M,Abate N,Kajanaku A,Duncan I,Gee JC,Rizi RR

    更新日期:2020-11-01 00:00:00

  • Propofol-induced Changes in α-β Sensorimotor Cortical Connectivity.

    abstract:BACKGROUND:Anesthetics are believed to alter functional connectivity across brain regions. However, network-level analyses of anesthesia, particularly in humans, are sparse. The authors hypothesized that propofol-induced loss of consciousness results in functional disconnection of human sensorimotor cortices underlying...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000001940

    authors: Malekmohammadi M,AuYong N,Price CM,Tsolaki E,Hudson AE,Pouratian N

    更新日期:2018-02-01 00:00:00

  • The effect of neuromuscular blockade with vecuronium on hemodynamic responses to noxious stimuli in the rat.

    abstract::The effect of neuromuscular blockade with vecuronium on the hemodynamic responses to a noxious stimulus was investigated in male Sprague-Dawley rats. The rats were anesthetized with either halothane (group 1, n = 10), or isoflurane (group 2, n = 10). The maximum values for heart rate and mean arterial pressure during ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198908000-00009

    authors: Gibbs NM,Larach DR,Schuler HG

    更新日期:1989-08-01 00:00:00

  • Halothane and the beating response and ATP turnover rate of heart cells in tissue culture.

    abstract::The effects of halothane on the beating response of rat heart cells in tissue culture were studied using an optical-electronic monitoring device. A dose-response curve was obtained over a concentration range to as much as 5 vol per cent halothane. The clinical dosage of 1 vol per cent halothane decreased the inotropic...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197502000-00003

    authors: Stong LJ,Hartzell CR,McCarl RL

    更新日期:1975-02-01 00:00:00

  • Preoperative orthostatic dysfunction is associated with an increased incidence of postoperative nausea and vomiting.

    abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) occurs frequently after gynecologic surgery. Because hemodynamic condition seems to be influential, women presenting with preoperative orthostatic dysregulation may have an increased risk for PONV. The aim of the present study was to assess the relationship between pr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200206000-00017

    authors: Pusch F,Berger A,Wildling E,Zimpfer M,Moser M,Sam C,Krafft P

    更新日期:2002-06-01 00:00:00