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. Tuohy needles were inserted into midthoracic spine at adjacent interspaces, one to measure pressure in the epidural space and one for fluid infusion. A third Tuohy needle was inserted in the lumbar epidural space. Fluid was infused at a constant flow (0.9-3.1 mL/min) until epidural space pressure reached a steady plateau, then the pump was shut off, and pressure returned to baseline over 5 to 6 mins. Resistance was calculated as the ratio of plateau pressure and flow. Initial (first 20-30 secs) and late (1-5 mins) capacitance was calculated. Measurements were made with the animal alive, 15 mins after its life was terminated by an intravenous injection of KCl, and then after exsanguination. RESULTS:During fluid infusion, the pressure gradient between the lumbar and thoracic epidural space was small, on the order of 1 to 2 mm Hg. Death reduced resistance but not capacitance, whereas exsanguination reduced late capacitance but not resistance. Neither maneuver affected initial capacitance. CONCLUSIONS:There is a small longitudinal pressure gradient within the epidural space during fluid infusion. Hence, the major source of resistance occurs where fluid leaves the epidural space. Death reduced resistance, perhaps by depressurizing spinal arteries in the intervertebral foramina, but did not affect capacitance. Blood in epidural veins is a major determinant of late epidural capacitance.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Blix EU,Buffington CWdoi
10.1097/AAP.0b013e3181958fadsubject
Has Abstractpub_date
2009-03-01 00:00:00pages
116-21issue
2eissn
1098-7339issn
1532-8651pii
00115550-200903000-00007journal_volume
34pub_type
杂志文章abstract：BACKGROUND AND OBJECTIVES:A variety of brachial plexus block techniques via the interscalene approach have been proposed. We describe here a new middle interscalene perivascular approach to the brachial plexus. To verify its effectiveness, we studied 719 patients scheduled for shoulder arthroscopy. Furthermore, to veri...
journal_title：Regional anesthesia and pain medicine
pub_type： 临床试验,杂志文章
doi：10.1016/j.rapm.2006.05.015
更新日期：2006-11-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Anesthesiologists are increasingly utilizing the Internet for personal and professional purposes. Without guidance, the task of searching the Internet for information may be time-consuming and frustrating. This article includes a basic introduction to the Internet with suggestions and guidelin...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,评审
doi：10.1016/s1098-7339(99)90115-3
更新日期：1999-07-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:The posterior approach to performing a continuous brachial plexus block at the level of the nerve roots has been described using traditional superficial landmarks. We describe an ultrasound-guided approach for the placement of a continuous interscalene brachial plexus catheter at the level of ...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/AAP.0b013e3181933a53
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:We present an unusual complication of epidural analgesia used to facilitate postoperative pain relief while allowing mobilization of the patient. CASE REPORT:A 65-year-old woman with a history of chronic obstructive pulmonary disease, atherosclerotic cardiovascular disease, chronic renal failu...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1053/rapm.2001.22993
更新日期：2001-05-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Ultrasound-guided regional anesthesia is a rapidly growing field. There exists little information regarding the competencies involved with such a practice. The objective of this exploratory study was to characterize the behavior of novices as they undertook the challenges of learning a new tec...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/j.rapm.2006.11.006
更新日期：2007-03-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Major ankle surgery causes intense postoperative pain, and whereas the importance of a sciatic nerve block is well established, the clinical significance of a supplemental saphenous nerve block has never been determined in a prospective, randomized, double-blind, placebo-controlled trial. We h...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1097/AAP.0000000000000764
更新日期：2018-07-01 00:00:00
abstract：OBJECTIVE:To describe a late neurologic complication of intrathecal pump implantation and show the methods used for the diagnosis and successful treatment of transverse myelitis in this setting. CASE REPORT:A 32-year-old man with a chronic abdominal pain syndrome presented with right lower-extremity numbness 2 months ...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/s1098-7339(03)00222-0
更新日期：2003-09-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:This prospective, randomized, and multicentered study was undertaken to evaluate the success rate of coracoid infraclavicular nerve block performed with a nerve stimulator when either 1 or 3 motor responses were sought. METHODS:Eighty patients who presented for elbow, forearm, or wrist surger...
journal_title：Regional anesthesia and pain medicine
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1053/rapm.2002.36456
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:The current intensity at which a motor response is elicited with an intraneural needle placement has been inadequately studied. We hypothesized that electrical current delivered through an intraneurally placed needle does not always result in an evoked motor response. Our secondary objective w...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/j.rapm.2007.12.010
更新日期：2008-05-01 00:00:00
abstract：:Shoulder surgery is associated with significant postoperative pain in many patients. The use of an interscalene nerve block offers good analgesia but is associated with a high incidence of an ipsilateral phrenic nerve block. Several strategies to avoid this adverse effect have been studied. Possible strategies are (1)...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1097/AAP.0b013e318272195d
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:The effect of intravenous dexamethasone on the duration of axillary plexus block performed using ropivacaine is not described. The aim of this study is to assess the effect of intravenous dexamethasone on the duration of axillary plexus block analgesia after distal upper arm surgery. METHODS:...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,随机对照试验
doi：10.1136/rapm-2018-100035
更新日期：2019-03-01 00:00:00
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
更新日期：2019-01-01 00:00:00
abstract：UNLABELLED:Neurologic injury after regional anesthesia or pain medicine procedures is rare. Postprocedural neurologic deficits may create high levels of anxiety for the patient and practitioner, although most deficits are limited in severity and can be expected to fully resolve with time. Postoperative anesthesia-relat...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,评审
doi：10.1097/AAP.0000000000000185
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:This prospective, randomized, double-blind study compared the effects of the ultrasound-guided popliteal sciatic nerve block performed by either intraneural or subparaneural approach followed by an electrophysiological evaluation. We hypothesized that intraneural injection provides a faster on...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,随机对照试验
doi：10.1097/AAP.0000000000000413
更新日期：2016-07-01 00:00:00
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
更新日期：2008-05-01 00:00:00
abstract：OBJECTIVE:We report a case of perioperative management of a single-ventricle patient with Fontan-associated liver disease undergoing hepatectomy. CASE REPORT:A 12-year-old boy with Fontan circulation was scheduled for partial hepatectomy to remove a liver mass in segment 6. He received stent implantation to relieve co...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1097/AAP.0000000000000316
更新日期：2015-11-01 00:00:00
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
更新日期：2011-05-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Peripheral nerve stimulation (PNS) is analgesic for some lower extremity neuropathic pain syndromes. PNS currently involves open surgical placement of electrode(s). Increasingly, ultrasound guidance is used for perioperative neural block. Minimally invasive placement of PNS electrodes for lowe...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/j.rapm.2008.04.007
更新日期：2008-11-01 00:00:00
abstract：BACKGROUND:A growing body of evidence indicates that the use of regional anesthesia offers advantages over general anesthesia, not only in terms of reducing complications but also regarding resource utilization and patient satisfaction. Because of the paucity of data on the nationwide adoption of regional anesthesia te...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1097/AAP.0000000000000342
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Chronic pain is both prevalent and costly. Despite advances in understanding the anatomy, physiology, and biochemistry of nociception and development of potent analgesic agents and advanced technology, a significant number of people continue to experience pain and related disability. The perce...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,评审
doi：10.1016/s1098-7339(03)00392-4
更新日期：2003-11-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Epinephrine, 25 microg and 200 microg, has been found to prolong the duration of intrathecal labor analgesia when added to an opioid. In our hospital we use the standard epidural mixture, prepared by the pharmacist, containing epinephrine 1:800,000; i.e., 1.25 microg/mL for both spinal and epi...
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.2001.24406
更新日期：2001-09-01 00:00:00
abstract：:The surgeon August Gustav Bier significantly influenced surgery, general medicine, and especially anesthesia. He was the father of spinal anesthesia (1898) and intravenous regional anesthesia (1908). Both anesthetic techniques are still valuable and widely applied in everyday anesthesia practices throughout the world,...
journal_title：Regional anesthesia and pain medicine
pub_type： 传,历史文章,杂志文章
doi：10.1016/j.rapm.2008.04.011
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:Ivor-Lewis esophagectomy is associated with significant postoperative analgesic requirements and perioperative complications. A dual-epidural technique may improve perioperative outcomes compared with single thoracic epidural analgesia. METHODS:This study identified all cases of Ivor-Lewis esophagectomy ove...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1097/AAP.0b013e318276a714
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND:This prospective, randomized, observer-blinded study compared ultrasound guidance and the conventional landmark-based technique for superficial cervical plexus blockade. METHODS:Forty patients were randomly allocated to receive a block of the superficial cervical plexus using ultrasound guidance (n = 20) or...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,随机对照试验
doi：10.1097/AAP.0b013e3181faa11c
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Cluster headache is an uncommon debilitating condition for which effective management remains a challenge. We describe the use of gabapentin in the treatment and prophylaxis of cluster headache in a patient who was refractory to other treatments. CASE REPORT:A 38-year-old man had a history of...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1053/rapm.2001.24404
更新日期：2001-07-01 00:00:00
abstract：OBJECTIVE:Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is ...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1097/AAP.0000000000000608
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Neosaxitoxin (NeoSTX) is a potent site-1 sodium-channel blocker being developed as a local anesthetic. Doses of 100 μg have been used by local infiltration in anesthetized adult humans without adverse effect. We hypothesized that similar doses could cause significant respiratory, neuromuscular, and cardiovas...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1097/AAP.0b013e3182424566
更新日期：2012-03-01 00:00:00
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
更新日期：2010-09-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Accurate needle control during ultrasound (US)-guided nerve blocks may be an elusive goal for the anesthesiologist. Despite modifications to increase echogenicity, needle visibility still requires precise alignment within the transducer beam. In this study, we evaluated a magnetically guided u...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,随机对照试验
doi：10.1097/AAP.0000000000000390
更新日期：2016-05-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Morphine may elicit potent antinociceptive effects by binding and activating peripheral opioid receptors. However, the results in clinical studies have varied. We examined the postoperative analgesic effects of incisional morphine in patients undergoing lumpectomies and axillary node dissectio...
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(99)90075-5
更新日期：1999-03-01 00:00:00
