Cervical spinal cord, root, and bony spine injuries: a closed claims analysis.


BACKGROUND:The aim of this study was to characterize cervical cord, root, and bony spine claims in the American Society of Anesthesiologists Closed Claims database to formulate hypotheses regarding mechanisms of injury. METHODS:All general anesthesia claims (1970-2007) in the Closed Claims database were searched to identify cervical injuries. Three independent teams, each consisting of an anesthesiologist and neurosurgeon, used a standardized review form to extract data from claim summaries and judge probable contributors to injury. RESULTS:Cervical injury claims (n = 48; mean ± SD age 47 ± 15 yr; 73% male) comprised less than 1% of all general anesthesia claims. When compared with other general anesthesia claims (19%), cervical injury claims were more often permanent and disabling (69%; P < 0.001). In addition, cord injuries (n = 37) were more severe than root and/or bony spine injuries (n = 10; P < 0.001), typically resulting in quadriplegia. Although anatomic abnormalities (e.g., cervical stenosis) were often present, cord injuries usually occurred in the absence of traumatic injury (81%) or cervical spine instability (76%). Cord injury occurred with cervical spine (65%) and noncervical spine (35%) procedures. Twenty-four percent of cord injuries were associated with the sitting position. Probable contributors to cord injury included anatomic abnormalities (81%), direct surgical complications (24% [38%, cervical spine procedures]), preprocedural symptomatic cord injury (19%), intraoperative head/neck position (19%), and airway management (11%). CONCLUSION:Most cervical cord injuries occurred in the absence of traumatic injury, instability, and airway difficulties. Cervical spine procedures and/or sitting procedures appear to predominate. In the absence of instability, cervical spondylosis was the most common factor associated with cord injury.






Hindman BJ,Palecek JP,Posner KL,Traynelis VC,Lee LA,Sawin PD,Tredway TL,Todd MM,Domino KB




Has Abstract


2011-04-01 00:00:00












  • The effects of diazepam on cerebral blood flow and oxygen consumption in rats and its synergistic interaction with nitrous oxide.

    abstract::The effects of diazepam on cerebral blood flow (CBF) and cerebral oxygen uptake (CMRO2) was studied using a 133xenon modification of the Kety-Schmidt (1948) technique in paralyzed, artifically ventilated rats with and without simultaneous administration of 70 per cent nitrous oxide. Diazepam was given iv in doses that...


    pub_type: 杂志文章


    authors: Carlsson C,Hgerdal M,Kaasik AE,Siesjö BK

    更新日期:1976-09-01 00:00:00

  • Antioxidants protect calsequestrin-1 knockout mice from halothane- and heat-induced sudden death.

    abstract:BACKGROUND:Mice lacking calsequestrin-1 (CASQ1-null), a Ca-binding protein that modulates the activity of Ca release in the skeletal muscle, exhibit lethal hypermetabolic episodes that resemble malignant hyperthermia in humans when exposed to halothane or heat stress. METHODS:Because oxidative species may play a criti...


    pub_type: 杂志文章


    authors: Michelucci A,Paolini C,Canato M,Wei-Lapierre L,Pietrangelo L,De Marco A,Reggiani C,Dirksen RT,Protasi F

    更新日期:2015-09-01 00:00:00

  • Enhanced cerebral blood flow autoregulation in the newborn piglet by d-tubocurarine and pancuronium but not by vecuronium.

    abstract::Neuromuscular blockers may affect cerebral blood flow (CBF) regulation in the newborn. We studied the effects of d-tubocurarine (0.1 mg.kg-1, n = 8), pancuronium (0.1 and 0.4 mg.kg-1, n = 6 and 7), and vecuronium (0.1 and 0.4 mg.kg-1, n = 6 and 7) on CBF measured over the same range of mean systemic blood pressure ([B...


    pub_type: 杂志文章


    authors: Chemtob S,Barna T,Beharry K,Aranda JV,Varma DR

    更新日期:1992-02-01 00:00:00

  • Liability associated with obstetric anesthesia: a closed claims analysis.

    abstract:BACKGROUND:Obstetrics carries high medical liability risk. Maternal death and newborn death/brain damage were the most common complications in obstetric anesthesia malpractice claims before 1990. As the liability profile may have changed over the past two decades, the authors reviewed recent obstetric claims in the Ame...


    pub_type: 杂志文章


    authors: Davies JM,Posner KL,Lee LA,Cheney FW,Domino KB

    更新日期:2009-01-01 00:00:00

  • Comparative analgesic and mental effects of increasing plasma concentrations of dexmedetomidine and alfentanil in humans.

    abstract:BACKGROUND:In animals, systemic and intrathecal administration of the alpha2 -adrenergic receptor agonist dexmedetomidine results in robust antinociceptive effects in models of heat pain. In humans, systemically administered dexmedetomidine is approved for sedating patients in the intensive care unit. However, whether ...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Angst MS,Ramaswamy B,Davies MF,Maze M

    更新日期:2004-09-01 00:00:00

  • Isoflurane activates intestinal sphingosine kinase to protect against renal ischemia-reperfusion-induced liver and intestine injury.

    abstract:BACKGROUND:Renal ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury and often leads to multiorgan dysfunction and systemic inflammation. Volatile anesthetics have potent antiinflammatory effects. We aimed to determine whether the representative volatile anesthetic isoflurane protects against acut...


    pub_type: 杂志文章


    authors: Kim M,Park SW,Kim M,D'Agati VD,Lee HT

    更新日期:2011-02-01 00:00:00

  • Effect of direct fetal opioid analgesia on fetal hormonal and hemodynamic stress response to intrauterine needling.

    abstract:BACKGROUND:Whether the fetus can experience pain remains controversial. During the last half of pregnancy, the neuroanatomic connections for nociception are in place, and the human fetus mounts sizable stress responses to physical insults. Analgesia has been recommended for intrauterine procedures or late termination, ...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Fisk NM,Gitau R,Teixeira JM,Giannakoulopoulos X,Cameron AD,Glover VA

    更新日期:2001-10-01 00:00:00

  • Epigastric antinociception by cervical dorsal column lesions in rats.

    abstract:BACKGROUND:Previous clinical evidence and electrophysiologic studies in the authors' laboratory have implicated the dorsal column (DC) as an important pathway for the transmission of visceral colorectal pain. This study examined, behaviorally and electrophysiologically, the role of the DC in mediating epigastric nocice...


    pub_type: 杂志文章


    authors: Feng Y,Cui M,Al-Chaer ED,Willis WD

    更新日期:1998-08-01 00:00:00

  • Reversible inhibition of rapid axonal transport in vivo by lidocaine hydrochloride.

    abstract::Rats were given standardized injections of 3H-L-proline into the trigeminal ganglion and 14C-lidocaine hydrochloride at the infraorbital foramen. The 3H-L-proline was always injected 2.5 h before removal of the nerve. Lidocaine, 1, 2, and 4%, produced a concentration-related inhibition of entry of 3H-labeled rapid axo...


    pub_type: 杂志文章


    authors: Fink BR,Kish SJ

    更新日期:1976-02-01 00:00:00

  • Alveolar-to-arterial-to-venous anesthetic partial pressure differences in humans.

    abstract::To determine the correlation between the partial pressures of anesthetics in venous and arterial blood (Pv and Pa), and to assess whether this correlation was better than that between the partial pressure of anesthetic in alveolar gas (PA) and Pa, isoflurane (n = 4) or halothane (n = 4) was administered to eight patie...


    pub_type: 杂志文章


    authors: Carpenter RL,Eger EI 2nd

    更新日期:1989-04-01 00:00:00

  • Effect of nitrous oxide on the oxyhemoglobin dissociation curve and PO2 measurements.

    abstract::Blood from 20 ASA physical status I patients collected before and after induction of anesthesia was used in vitro to reexamine the effects of nitrous oxide on the oxyhemoglobin dissociation curve and the response of the oxygen electrode. The preinduction P50 values with and without 70% N2O were 28.4 +/- 0.1 mmHg and 2...


    pub_type: 杂志文章


    authors: Kambam JR,Holaday DA

    更新日期:1987-02-01 00:00:00

  • Complications of different ventilation strategies in endoscopic laryngeal surgery: a 10-year review.

    abstract:BACKGROUND:Spontaneous ventilation, mechanical controlled ventilation, apneic intermittent ventilation, and jet ventilation are commonly used during interventional suspension microlaryngoscopy. The aim of this study was to investigate specific complications of each technique, with special emphasis on transtracheal and ...


    pub_type: 杂志文章


    authors: Jaquet Y,Monnier P,Van Melle G,Ravussin P,Spahn DR,Chollet-Rivier M

    更新日期:2006-01-01 00:00:00

  • Psychedelic effects of ketamine in healthy volunteers: relationship to steady-state plasma concentrations.

    abstract:BACKGROUND:Ketamine has been associated with a unique spectrum of subjective "psychedelic" effects in patients emerging from anesthesia. This study quantified these effects of ketamine and related them to steady-state plasma concentrations. METHODS:Ketamine or saline was administered in a single-blinded crossover prot...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Bowdle TA,Radant AD,Cowley DS,Kharasch ED,Strassman RJ,Roy-Byrne PP

    更新日期:1998-01-01 00:00:00

  • Effect of antiemetic therapy on recovery and hospital discharge time. A double-blind assessment of ondansetron, droperidol, and placebo in pediatric patients undergoing ambulatory surgery.

    abstract:BACKGROUND:Postoperative nausea and vomiting continue to be a significant problem for pediatric ambulatory surgery patients. Although ondansetron has been demonstrated to be effective in the prophylactic treatment of postoperative nausea and vomiting (surrogate end point) no one has demonstrated a benefit of antiemetic...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Davis PJ,McGowan FX Jr,Landsman I,Maloney K,Hoffmann P

    更新日期:1995-11-01 00:00:00

  • Factor VII levels and international normalized ratios in the early phase of warfarin therapy.

    abstract:BACKGROUND:Factor VII is the most affected clotting factor during the early phase of warfarin therapy. An international normalized ratio (INR) of more than 1.4 is considered unsafe for epidural catheter placement or removal, according to the American Society of Regional Anesthesia and Pain Medicine. The authors tested ...


    pub_type: 杂志文章


    authors: Benzon HT,Avram MJ,Benzon HA,Kirby-Nolan M,Nader A

    更新日期:2010-02-01 00:00:00

  • Association between Use of Angiotensin-converting Enzyme Inhibitors or Angiotensin Receptor Blockers and Postoperative Delirium.

    abstract:BACKGROUND:Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers improve cognitive function. The authors therefore tested the primary hypothesis that preoperative use of angiotensin inhibitors is associated with less delirium in critical care patients. Post hoc, the association between postoperativ...


    pub_type: 杂志文章


    authors: Farag E,Liang C,Mascha EJ,Argalious MY,Ezell J,Maheshwari K,Esa WAS,Troianos CA,Sessler DI

    更新日期:2020-07-01 00:00:00

  • Negative and positive inotropic effects of propofol via L-type calcium channels and the sodium-calcium exchanger in rat cardiac trabeculae.

    abstract:BACKGROUND:Conflicting opinions are present in the literature regarding the origin of the negative inotropic effect of propofol on the myocardium. This study aims to resolve these discrepancies by investigating the inotropic effects of propofol the L-type calcium channels and the sodium-calcium exchanger (NCX). METHOD...


    pub_type: 杂志文章


    authors: de Ruijter W,Stienen GJ,van Klarenbosch J,de Lange JJ

    更新日期:2002-11-01 00:00:00

  • Effect of cricoid pressure on the success of endotracheal intubation with a lightwand.

    abstract:BACKGROUND:The lightwand may be useful as an alternative for tracheal intubation during a rapid-sequence induction of anesthesia in the presence of a full stomach. This study was undertaken to assess the effect of application of cricoid pressure on the success of lightwand intubation. METHODS:Sixty adult female patien...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Hodgson RE,Gopalan PD,Burrows RC,Zuma K

    更新日期:2001-02-01 00:00:00

  • Cerebral cortex activation during experimentally induced ventilator fighting in normal humans receiving noninvasive mechanical ventilation.

    abstract:BACKGROUND:Mechanical ventilation is delivered to sedated patients during anesthesia, but also to nonsedated patients (ventilator weaning, noninvasive ventilation). In these circumstances, patient-ventilator asynchrony may occur, provoking discomfort and unduly increasing work of breathing. In certain cases, it is asso...


    pub_type: 杂志文章


    authors: Raux M,Ray P,Prella M,Duguet A,Demoule A,Similowski T

    更新日期:2007-11-01 00:00:00

  • Halothane and isoflurane decrease alveolar epithelial fluid clearance in rats.

    abstract:BACKGROUND:Active sodium transport is the primary mechanism that drives alveolar fluid clearance. In the current study, the effects of exposure to halothane and isoflurane on alveolar fluid clearance in rats were evaluated. METHODS:Rats were exposed to either halothane (0.4% for 6 h or 2% for 2 h) or isoflurane (0.6% ...


    pub_type: 杂志文章


    authors: Rezaiguia-Delclaux S,Jayr C,Luo DF,Saïdi NE,Meignan M,Duvaldestin P

    更新日期:1998-03-01 00:00:00

  • Cerebral blood flow and cerebral oxygen consumption during nitroprusside-induced hypotension to less than 50 mmHg.

    abstract::The authors determined the effect of profound induced hypotension (i.e., mean arterial blood pressure less than 50 mmHg) during craniotomy for cerebral aneurysm on cerebral blood flow and cerebral metabolic rate for oxygen before, during, and after (20 min and 40 min after) the hypotensive period. The study was perfor...


    pub_type: 杂志文章


    authors: Pinaud M,Souron R,Lelausque JN,Gazeau MF,Lajat Y,Dixneuf B

    更新日期:1989-02-01 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 ...


    pub_type: 杂志文章


    authors: Shanks CA,Somogyi AA,Triggs EJ

    更新日期:1979-08-01 00:00:00

  • Benefit versus Severe Side Effects of Opioid Analgesia: Novel Utility Functions of Probability of Analgesia and Respiratory Depression.

    abstract:BACKGROUND:Previous studies integrated opioid benefit and harm into one single function-the utility function-to determine the drug toxicity (respiratory depression) in light of its wanted effect (analgesia). This study further refined the concept of the utility function using the respiratory and analgesic effects of th...


    pub_type: 杂志文章


    authors: Roozekrans M,van der Schrier R,Aarts L,Sarton E,van Velzen M,Niesters M,Dahan A,Olofsen E

    更新日期:2018-05-01 00:00:00

  • A clinical grading scale to predict malignant hyperthermia susceptibility.

    abstract:BACKGROUND:The diagnosis of an acute malignant hyperthermia reaction by clinical criteria can be difficult because of the nonspecific nature and variable incidence of many of the clinical signs and laboratory findings. Development of a standardized means for estimating the qualitative likelihood of malignant hypertherm...


    pub_type: 杂志文章


    authors: Larach MG,Localio AR,Allen GC,Denborough MA,Ellis FR,Gronert GA,Kaplan RF,Muldoon SM,Nelson TE,Ording H

    更新日期:1994-04-01 00:00:00

  • Effects of halothane and isoflurane on beta-adrenoceptor-mediated responses in the vascular smooth muscle of rat aorta.

    abstract:BACKGROUND:Although previous studies have proposed that anesthetics may influence signal transduction systems, their effects on the beta-adrenoceptor-mediated system have not been fully characterized in vascular smooth muscle. The aim of this study was to determine how halothane and isoflurane affect beta-adrenoceptor-...


    pub_type: 杂志文章


    authors: Tanaka S,Tsuchida H

    更新日期:1998-11-01 00:00:00

  • Neither xenon nor fentanyl induces neuroapoptosis in the newborn pig brain.

    abstract:BACKGROUND:Some inhalation anesthetics increase apoptotic cell death in the developing brain. Xenon, an inhalation anesthetic, increases neuroprotection when combined with therapeutic hypothermia after hypoxic-ischemic brain injury in newborn animals. The authors, therefore, examined whether there was any neuroapoptoti...


    pub_type: 杂志文章


    authors: Sabir H,Bishop S,Cohen N,Maes E,Liu X,Dingley J,Thoresen M

    更新日期:2013-08-01 00:00:00

  • Intracranial pressure during hypotension and subsequent vasopressor therapy in anesthetized cats.

    abstract::The effects of vasopressor therapy on intracranial pressure (ICP) during hypotension were evaluated in 45 adult cats anesthetized with pentobarbital and hyperventilated via an endotracheal tube with nitrous oxide, 70 per cent, and oxygen, 30 per cent, to maintain Paco2 25 plus or minus 5 torr. Hypotension was induced ...


    pub_type: 杂志文章


    authors: Stullken EH Jr,Sokoll MD

    更新日期:1975-04-01 00:00:00

  • Monitoring of pulmonary endothelial enzyme function: an animal model for a simplified clinically applicable procedure.

    abstract::The authors present a simple and clinically applicable method for the serial monitoring of pulmonary microvascular enzyme function in vivo. This method requires the intravenous injection of trace amounts of a radiolabelled substrate and the collection of a single arterial blood sample. Simultaneous measurement of pulm...


    pub_type: 杂志文章


    authors: Toivonen HJ,Makari N,Catravas JD

    更新日期:1988-01-01 00:00:00

  • Xenon does not increase heart rate-corrected cardiac QT interval in volunteers and in patients free of cardiovascular disease.

    abstract:BACKGROUND:Impaired cardiac repolarization, indicated by prolonged QT interval, may cause critical ventricular arrhythmias. Many anesthetics increase the QT interval by blockade of rapidly acting potassium rectifier channels. Although xenon does not affect these channels in isolated cardiomyocytes, the authors hypothes...


    pub_type: 临床试验,杂志文章


    authors: Neukirchen M,Schaefer MS,Kern C,Brett S,Werdehausen R,Rellecke P,Reyle-Hahn M,Kienbaum P

    更新日期:2015-09-01 00:00:00

  • Drug actions at mammalian motor nerve endings: the suppression of neostigmine-induced fasciculations by vecuronium and isoflurane.

    abstract::The occurrence of fasciculations following administration of agents is a well-known pharmacologic phenomenon. Using the cat soleus nerve-muscle preparation, intravenous neostigmine doses between 20-200 micrograms/kg evoked fasciculations in a dose-related manner. The data demonstrate that the fasciculations were the r...


    pub_type: 杂志文章


    authors: Baker T,Stanec A

    更新日期:1987-12-01 00:00:00