Divergence paresis without positional headache: an unusual presentation of cerebrospinal fluid hypovolemia after spinal anesthesia.


:We report a rare complication of spinal anesthesia-divergence paresis-which is characterized by an acquired horizontal diplopia at distance without evidence for abducens palsy. A 64-yr-old man underwent prostatectomy under spinal anesthesia with 2.5 mL of dibucaine hydrochloride 0.3% injected through a 20-gauge cutting-tip spinal needle. Seventeen days after the operation, the patient noticed horizontal diplopia for distant objects. Although cranial magnetic resonance imaging demonstrated diffuse pachymeningeal gadolinium enhancement and subdural effusion, characteristic findings of cerebrospinal fluid hypovolemia, the patient had no positional headache. Gadolinium-enhanced magnetic resonance imaging may be useful when a patient develops neurologic symptoms after dural puncture.


Anesth Analg


Anesthesia and analgesia


Arai M,Matsushima S,Terada H




Has Abstract


2006-06-01 00:00:00














  • Posterior tibial nerve sensory blockade duration prolonged by adding dexmedetomidine to ropivacaine.

    abstract:BACKGROUND:Dexmedetomidine, an α(2)-receptor agonist, prolongs analgesia when used in neuraxial and IV blocks. We evaluated the effect of dexmedetomidine added to ropivacaine for tibial nerve block on the duration of the sensory blockade. METHODS:For this prospective, randomized, controlled, double-blind, crossover tr...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Rancourt MP,Albert NT,Côté M,Létourneau DR,Bernard PM

    更新日期:2012-10-01 00:00:00

  • The prevalence and significance of low preoperative hemoglobin in ASA 1 or 2 outpatient surgery candidates.

    abstract::Asymptomatic anemia in healthy patients undergoing low risk surgery is rare. In this retrospective study, we examined the records of 9584 ASA class I-II patients scheduled for elective low risk surgery who had a preoperative hemoglobin (hgb) test for the presence of anemia. Hgb <9 g/dL was detected in 75 patients (0.8...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Olson RP,Stone A,Lubarsky D

    更新日期:2005-11-01 00:00:00

  • Induction of anesthesia with ketamine reduces the magnitude of redistribution hypothermia.

    abstract:UNLABELLED:Hypothermia after induction of general anesthesia results largely from core-to-peripheral redistribution of body heat. Both central inhibition of tonic thermoregulatory vasoconstriction in arteriovenous shunts and anesthetic-induced arteriolar and venous dilation contribute to this redistribution. Ketamine, ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Ikeda T,Kazama T,Sessler DI,Toriyama S,Niwa K,Shimada C,Sato S

    更新日期:2001-10-01 00:00:00

  • Isoflurane bidirectionally modulates the paired-pulse responses in the rat hippocampal CA1 field in vivo.

    abstract:BACKGROUND:We studied the effects of isoflurane on hippocampal synaptic transmission and paired-pulse plasticity, under in vivo intact interneuron circuitry. METHODS:Using rats chronically implanted with electrodes, excitatory postsynaptic potential (EPSP) and population spike amplitude (PSA) were measured in the hipp...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Tachibana K,Takita K,Hashimoto T,Matsumoto M,Yoshioka M,Morimoto Y

    更新日期:2007-10-01 00:00:00

  • The anesthetic considerations in patients with ventricular assist devices presenting for noncardiac surgery: a review of eight cases.

    abstract:IMPLICATIONS:The number of patients supported by ventricular assist devices (VADs) that present for noncardiac surgery is increasing in our institution. Our recent experience with eight such patients is reported, along with a review of the most commonly implanted VADs and the anesthetic implications and considerations ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Stone ME,Soong W,Krol M,Reich DL

    更新日期:2002-07-01 00:00:00

  • Determining optimum operating room utilization.

    abstract:UNLABELLED:Economic considerations suggest that it is desirable to keep operating rooms fully used when staffed, but the optimum utilization of an operating room (OR) is not known. We created a simulation of an OR to define optimum utilization. We set operational goals of having cases start within 15 min of the schedul...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Tyler DC,Pasquariello CA,Chen CH

    更新日期:2003-04-01 00:00:00

  • Hyperkalemic cardiac arrest after cardiopulmonary bypass in a child with unsuspected duchenne muscular dystrophy.

    abstract::Adverse reactions to volatile anesthetics and depolarizing muscle relaxants can occur in patients with Duchenne muscular dystrophy (DMD) resulting in acute rhabdomyolysis and hyperkalemia. We report a case of hyperkalemic cardiac arrest after cardiac surgery using cardiopulmonary bypass in a child with unsuspected DMD...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Nathan A,Ganesh A,Godinez RI,Nicolson SC,Greeley WJ

    更新日期:2005-03-01 00:00:00

  • Refinement of symptoms of neuropathic pain measurements after various transections of the nerve endings of the sciatic and femoral nerve in rats: an exploratory behavioral analysis.

    abstract:BACKGROUND:Many animal models can be used to study the underlying pathophysiological mechanisms of neuropathic pain. Most of these models rely on a partial denervation of the limb of the animal by ligating a selected nerve. In this study, we performed nerve lesions on three peripheral nerves supplying the plantar side ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Van Remoortere MP,Meert TF,Vissers KC,Coppenolle H,Adriaensen H

    更新日期:2007-05-01 00:00:00

  • A prospective comparison of a noninvasive cardiac output monitor versus esophageal Doppler monitor for goal-directed fluid therapy in colorectal surgery patients.

    abstract:BACKGROUND:Goal-directed fluid therapy (GDFT) is associated with improved outcomes after surgery. The esophageal Doppler monitor (EDM) is widely used, but has several limitations. The NICOM, a completely noninvasive cardiac output monitor (Cheetah Medical), may be appropriate for guiding GDFT. No prospective studies ha...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Waldron NH,Miller TE,Thacker JK,Manchester AK,White WD,Nardiello J,Elgasim MA,Moon RE,Gan TJ

    更新日期:2014-05-01 00:00:00

  • Estimation of optimal modeling weights for a Bayesian-based closed-loop system for propofol administration using the bispectral index as a controlled variable: a simulation study.

    abstract:BACKGROUND:Implementing Bayesian methods in a model-based closed-loop system requires the integration of a standard response model with a patient-specific response model. This process makes use of specific modeling weights, called Bayesian variances, which determine how the specific model can deviate from the standard ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: De Smet T,Struys MM,Greenwald S,Mortier EP,Shafer SL

    更新日期:2007-12-01 00:00:00

  • Closed-Loop Delivery Systems Versus Manually Controlled Administration of Total IV Anesthesia: A Meta-analysis of Randomized Clinical Trials.

    abstract::Bispectral Index Scale (BIS)-guided closed-loop delivery of anesthetics has been extensively studied. We performed a meta-analysis of all the randomized clinical trials comparing efficacy and performance between BIS-guided closed-loop delivery and manually controlled administration of total IV anesthesia. Scopus, PubM...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析,评审


    authors: Pasin L,Nardelli P,Pintaudi M,Greco M,Zambon M,Cabrini L,Zangrillo A

    更新日期:2017-02-01 00:00:00

  • Hyperglycemia impairs isoflurane-induced adenosine triphosphate-sensitive potassium channel activation in vascular smooth muscle cells.

    abstract:BACKGROUND:Isoflurane activates vascular adenosine triphosphate sensitive potassium (K(ATP)) channels, and may induce vasodilation. In the present study, we investigated whether hyperglycemia modifies isoflurane activation of vascular K(ATP) channel. METHODS:We used a cell-attached patch-clamp configuration to test th...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Kawano T,Tanaka K,Mawatari K,Oshita S,Takahashi A,Nakaya Y

    更新日期:2008-03-01 00:00:00

  • Fresh-Frozen Plasma: Ordering Patterns and Utilization in the Operating Rooms of a Tertiary Referral Hospital.

    abstract:BACKGROUND:Blood product transfusion is the most commonly performed hospital procedure. Intraoperative blood product utilization varies between institutions and anesthesiologists. In the United States in 2011, nearly 4 million plasma units were transfused. METHODS:A retrospective analysis of intraoperative plasma orde...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Meyer MJ,Dzik WH,Levine WC

    更新日期:2017-02-01 00:00:00

  • Central administration of minocycline and riluzole prevents morphine-induced tolerance in rats.

    abstract:BACKGROUND:Long-term exposure to opiates induces tolerance to the analgesic effect. The neurobiological mechanism of this phenomenon is not completely clear. In this study, we evaluated the effects of central administration of minocycline (a tetracycline derivative) and riluzole (an antiglutamatergic drug) on morphine-...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Habibi-Asl B,Hassanzadeh K,Charkhpour M

    更新日期:2009-09-01 00:00:00

  • The effect of GP683, an adenosine kinase inhibitor, on the desflurane anesthetic requirement in dogs.

    abstract:UNLABELLED:The availability of an analgesic compound devoid of the side effects associated with the commonly used opioid and nonsteroidal antiinflammatory drugs would be useful during the perioperative period. Although adenosine has analgesic and anesthetic-sparing properties, it also produces dose-dependent cardiovasc...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Wang B,Tang J,White PF,Foster AC,Grettenberger HM,Kopcho J,Wender RH

    更新日期:1997-09-01 00:00:00

  • Resuscitation from bupivacaine-induced asystole in rats: comparison of different cardioactive drugs.

    abstract::The objective of this study was to compare the success of resuscitation attempts with different cardioactive drugs after bupivacaine-induced asystole. Saline, amrinone (1 mg/kg), dopamine (5 micrograms/kg), norepinephrine (2 micrograms/kg), epinephrine (10 micrograms/kg), or isoproterenol (1 microgram/kg) were tested....

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Heavner JE,Pitkänen MT,Shi B,Rosenberg PH

    更新日期:1995-06-01 00:00:00

  • Choice of electrocardiography lead does not affect the usefulness of the T-wave criterion for detecting intravascular injection of an epinephrine test dose in anesthetized children.

    abstract:UNLABELLED:Accidental intravascular injection of an epinephrine-containing test dose increases T-wave amplitude of lead II electrocardiogram (EKG) in anesthetized children. We designed this study to test whether the choice of EKG lead would affect the usefulness of simulated intravascular test dose. We studied 32 ASA p...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Ogasawara K,Tanaka M,Nishikawa T

    更新日期:2003-08-01 00:00:00

  • Central poststroke pain: a review of pathophysiology and treatment.

    abstract:BACKGROUND:Central poststroke pain (CPSP) is a disabling morbidity occurring in 8%-14% of patients with stroke. It is infrequently recognized and difficult to manage. OBJECTIVE:We systematically reviewed the pathophysiology and treatment of CPSP. METHODS:We conducted a Medline search using the key words "central post...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Kumar B,Kalita J,Kumar G,Misra UK

    更新日期:2009-05-01 00:00:00

  • Changes in anterior fontanel pressure in preterm neonates receiving isoflurane, halothane, fentanyl, or ketamine.

    abstract::The effects of anesthetics on intracranial pressure (ICP) may be different in preterm neonates than in adults because the neonate's cranial sutures are not yet fused. The authors monitored changes in anterior fontanel pressure (AFP), a noninvasive indicator of ICP, during anesthesia in 44 preterm neonates without neur...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Friesen RH,Thieme RE,Honda AT,Morrison JE Jr

    更新日期:1987-05-01 00:00:00

  • Estimation of the length of the nares-vocal cord.

    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


    authors: Han DW,Shim YH,Shin CS,Lee YW,Lee JS,Ahn SW

    更新日期:2005-05-01 00:00:00

  • The evolution of perioperative transfusion testing and blood ordering.

    abstract::The evolution of modern anesthesia and surgical practices has been accompanied by enhanced supportive procedures in blood banking and transfusion medicine. There is increased focus on the preparation and the use of blood components including, but not limited to, preventing unnecessary type and screen/crossmatch orders...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: White MJ,Hazard SW 3rd,Frank SM,Boyd JS,Wick EC,Ness PM,Tobian AA

    更新日期:2015-06-01 00:00:00

  • Propacetamol as adjunctive treatment for postoperative pain after cardiac surgery.

    abstract:UNLABELLED:Postoperative pain management after cardiac surgery has been mainly based on parenteral opioids. However, because opioids have numerous side effects, coadministration of non-opioid analgesics has been introduced as a method of reducing opioid dose. In this prospective, randomized, double-blinded study, we ev...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Lahtinen P,Kokki H,Hendolin H,Hakala T,Hynynen M

    更新日期:2002-10-01 00:00:00

  • Lymph leakage following catheterization of the right subclavian vein.

    abstract::Leakge of lymph following puncture of the right subclavian vein occurred in a patient, requiring a pacemaker catheter. The lymph drainage settled spontaneously after 4 days on remanipulation of the pacing wire. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Ryan DW

    更新日期:1978-01-01 00:00:00

  • The antiinflammatory and analgesic effects of baicalin in carrageenan-evoked thermal hyperalgesia.

    abstract:UNLABELLED:We tested baicalin for its antiinflammatory and analgesic effects (and the mechanisms) in a rat model of carrageenan-evoked thermal hyperalgesia. Pre- or posttreatment with baicalin (10, 30, or 100 mg/kg intraperitoneally) caused a significant analgesic effect with a similar effect of dose-matched ibuprofen....

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Chou TC,Chang LP,Li CY,Wong CS,Yang SP

    更新日期:2003-12-01 00:00:00

  • The in vitro effects of isoflurane, sevoflurane, and propofol on platelet aggregation.

    abstract:UNLABELLED:We studied the in vitro effects of sevoflurane, isoflurane, and propofol anesthesia on platelet function. Thirty patients undergoing minor surgical procedures were divided into three groups (n = 10 each). Induction of anesthesia was achieved by using 5 mg/kg thiopental i.v., and 0.1 mg/kg vecuronium i.v. was...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Doğan IV,Ovali E,Eti Z,Yayci A,Göğüş FY

    更新日期:1999-02-01 00:00:00

  • Spontaneous positive end-expiratory pressure (sPEEP).

    abstract::Spontaneous positive end-expiratory pressure (sPEEP) is a simple, low-cost method of providing low to moderate levels of PEEP as an alternative to continuous positive airway pressure (CPAP), whether used alone or with continuous positive pressure ventilation (CPPV) in intermittent mandatory ventilation (IMV). The ther...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Gillick JS

    更新日期:1977-09-01 00:00:00

  • Time course of muscle relaxation with a combination of pancuronium and tubocurarine.

    abstract::A combination of pancuronium and d-tubocurarine is associated with potentiation of the neuromuscular blocking effects of each drug used singly. The time to onset of maximum block and the time to 25% recovery after administration of equipotent (ED95) doses of pancuronium (0.07 mg/kg) alone, d-tubocurarine (0.51 mg/kg) ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Mirakhur RK,Pandit SK,Ferres CJ,Gibson FM

    更新日期:1984-04-01 00:00:00

  • The effect of intravenous administration of dexamethasone on postoperative pain, nausea, and vomiting after intrathecal injection of meperidine.

    abstract:BACKGROUND:Different drugs have been used to enhance postoperative neuraxial opioid analgesia and reduce adverse effects. METHODS:We randomized 60 patients into 2 groups to receive either 2 mL saline or 0.1 mg/kg dexamethasone IV before the administration of intrathecal anesthesia (15 mg and meperidine 15 mg). After s...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Movafegh A,Soroush AR,Navi A,Sadeghi M,Esfehani F,Akbarian-Tefaghi N

    更新日期:2007-04-01 00:00:00

  • The effects of opioids on isolated human pregnant uterine muscles.

    abstract:UNLABELLED:We determined the effects of fentanyl, sufentanil, morphine, and meperidine on the spontaneous contractility of isolated human pregnant uterine muscle strips. Uterine specimens were obtained from normal full-term parturients undergoing elective lower-segment cesarean delivery. Longitudinal muscle strips were...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Yoo KY,Lee J,Kim HS,Jeong SW

    更新日期:2001-04-01 00:00:00

  • The Cognitive Science of Learning: Concepts and Strategies for the Educator and Learner.

    abstract::Education is the fundamental process used to develop and maintain the professional skills of physicians. Medical students, residents, and fellows are expected to learn considerable amounts of information as they progress toward board certification. Established practitioners must continue to learn in an effort to remai...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Weidman J,Baker K

    更新日期:2015-12-01 00:00:00