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












  • Lidocaine and pentylenetetrazol seizure thresholds in cats are not reduced after enflurane anesthesia.

    abstract::Some previous reports indicate that the excitability of the brain may be increased for days following enflurane anesthesia. The authors investigated this possibility in cats by determining whether or not pentylenetetrazol- (Metrazol) or lidocaine-seizure thresholds decreased after repeated enflurane exposure. The lido...


    pub_type: 杂志文章


    authors: Heavner JE,Amory DW

    更新日期:1981-05-01 00:00:00

  • Positive experimental demonstration of the negative brain "protective" effects of anesthetics following cardiac arrest.

    abstract::The cerebral metabolic effects of a massive dose of thiopental (177 mg/kg) were investigated in seven dogs. The systemic circulation was supported with an extracorporeal circuit. At an infusion rate of 2 mg/kg/min, cerebral oxygen consumption (CMR(O(2))) decreased progressively until cerebral electrical silence was pr...


    pub_type: 评论,杂志文章


    authors: Michenfelder JD

    更新日期:2002-10-01 00:00:00

  • Effects of propofol and thiopental in isolated rat aorta and pulmonary artery.

    abstract::This study was performed to determine if direct arterial dilating actions of propofol contribute to the drug's hypotensive actions. The effects of propofol were compared with those of thiopental on isolated vascular ring preparations from rat thoracic aorta and pulmonary artery. Thoracic aortic ring responses were eva...


    pub_type: 杂志文章


    authors: Park WK,Lynch C 3rd,Johns RA

    更新日期:1992-11-01 00:00:00

  • Differentiating Drug-related and State-related Effects of Dexmedetomidine and Propofol on the Electroencephalogram.

    abstract:BACKGROUND:Differentiating drug-related changes and state-related changes on the electroencephalogram during anesthetic-induced unconsciousness has remained a challenge. To distinguish these, we designed a rigorous experimental protocol with two drugs known to have distinct molecular mechanisms of action. We hypothesiz...


    pub_type: 杂志文章,随机对照试验


    authors: Scheinin A,Kallionpää RE,Li D,Kallioinen M,Kaisti K,Långsjö J,Maksimow A,Vahlberg T,Valli K,Mashour GA,Revonsuo A,Scheinin H

    更新日期:2018-07-01 00:00:00

  • Respiratory, laryngeal, and tracheal responses to nasal insufflation of volatile anesthetics in anesthetized humans.

    abstract::In order to determine whether or not irritation of the nasal passage with commonly used volatile anesthetics can elicit airway reflexes, we investigated respiratory, laryngeal, and tracheal responses to nasal insufflation of three volatile anesthetics (enflurane, isoflurane, and halothane) in 13 patients anesthetized ...


    pub_type: 杂志文章


    authors: Nishino T,Tanaka A,Ishikawa T,Hiraga K

    更新日期:1991-09-01 00:00:00

  • Are all preterm infants younger than 60 weeks postconceptual age at risk for postanesthetic apnea?

    abstract:BACKGROUND:Preterm and ex-preterm infants are at risk for life-threatening apnea after general anesthesia. The authors attempted to define the postconceptual age beyond which apnea is less likely to occur and to identify the factors that predispose to postanesthetic apnea. METHODS:Ninety-one infants younger than 60 we...


    pub_type: 杂志文章


    authors: Malviya S,Swartz J,Lerman J

    更新日期:1993-06-01 00:00:00

  • Large-dose hydroxyethyl starch 130/0.4 does not increase blood loss and transfusion requirements in coronary artery bypass surgery compared with hydroxyethyl starch 200/0.5 at recommended doses.

    abstract:BACKGROUND:Hydroxyethyl starch (HES) 130/0.4 may impair blood coagulation less than other HES solutions and, thus, may be used at larger doses without increasing the risk of postoperative bleeding. This study tested the hypothesis that volume replacement with 6% HES 130/0.4 at a dose of up to 50 ml/kg does not increase...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Kasper SM,Meinert P,Kampe S,Görg C,Geisen C,Mehlhorn U,Diefenbach C

    更新日期:2003-07-01 00:00:00

  • Pronociceptive effects of remifentanil in a mouse model of postsurgical pain: effect of a second surgery.

    abstract:BACKGROUND:Remifentanil anesthesia enhances postoperative pain in animals and humans. The authors evaluated the impact of the dose (microg x kg(-1) x min(-1)) and duration of remifentanil infusion, and the effects of a second surgery on postoperative pain sensitization. METHODS:Mice received different doses of remifen...


    pub_type: 杂志文章


    authors: Cabañero D,Campillo A,Célérier E,Romero A,Puig MM

    更新日期:2009-12-01 00:00:00

  • Time-dependent inhibition of G protein-coupled receptor signaling by local anesthetics.

    abstract:BACKGROUND:Several beneficial effects of local anesthetics (LAs) were shown to be due to inhibition of G protein-coupled receptor signaling. Differences in exposure time might explain discrepancies in concentrations of LAs required to achieve these protective effects in vivo and in vitro (approximately 100-fold higher)...


    pub_type: 杂志文章


    authors: Hollmann MW,Herroeder S,Kurz KS,Hoenemann CW,Struemper D,Hahnenkamp K,Durieux ME

    更新日期:2004-04-01 00:00:00

  • Both local anesthetics and salbutamol pretreatment affect reflex bronchoconstriction in volunteers with asthma undergoing awake fiberoptic intubation.

    abstract:BACKGROUND:Awake tracheal intubation may evoke reflex bronchoconstriction in asthmatics. Whether this effect is altered by the choice of the local anesthetic used or by pretreatment with a beta2-adrenoceptor agonist is unknown. Therefore, we assessed the effect of awake fiberoptic intubation after lidocaine or dyclonin...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Groeben H,Schlicht M,Stieglitz S,Pavlakovic G,Peters J

    更新日期:2002-12-01 00:00:00

  • Seizures during opioid anesthetic induction--are they opioid-induced rigidity?

    abstract::The tape recorded EEGs of 127 patients anesthetized with large doses of opioids were retrospectively analyzed for evidence of opioid-induced seizures, and in particular, correlated with movements that occurred during induction and could be clinically interpreted as seizures. Bilateral EEG leads in patients receiving f...


    pub_type: 杂志文章


    authors: Smith NT,Benthuysen JL,Bickford RG,Sanford TJ,Blasco T,Duke PC,Head N,Dec-Silver H

    更新日期:1989-12-01 00:00:00

  • Midazolam potentiates nociceptive behavior, sensitizes cutaneous reflexes, and is devoid of sedative action in neonatal rats.

    abstract:BACKGROUND:The significant postnatal maturation of gamma-aminobutyric acid signaling in the developing brain is likely to have important implications for infant pain processing. Gamma-aminobutyric acid receptor activation evokes analgesia and sedation in the adult, but the impact of immature gamma-aminobutyric acid sig...


    pub_type: 杂志文章


    authors: Koch SC,Fitzgerald M,Hathway GJ

    更新日期:2008-01-01 00:00:00

  • Cardiovascular changes in preterm neonates receiving isoflurane, halothane, fentanyl, and ketamine.

    abstract::Hemodynamic changes during four anesthetic techniques were studied in 80 preterm neonates. Atropine, 0.02 mg/kg, and pancuronium, 0.1 mg/kg, were given intravenously to all patients, who were ventilated with oxygen and air. Each group of 20 patients then received 0.75% isoflurane, 0.5% halothane, 20 micrograms/kg fent...


    pub_type: 杂志文章


    authors: Friesen RH,Henry DB

    更新日期:1986-02-01 00:00:00

  • The pharmacokinetics and hemodynamic effects of intravenous and intramuscular dexmedetomidine hydrochloride in adult human volunteers.

    abstract:BACKGROUND:Dexmedetomidine is an alpha 2 agonist with potential utility in clinical anesthesia for both its sedative and sympatholytic properties. METHODS:The pharmacokinetics and hemodynamic changes that occurred in ten healthy male volunteers were determined after administration of dexmedetomidine 2 micrograms/kg by...


    pub_type: 杂志文章


    authors: Dyck JB,Maze M,Haack C,Vuorilehto L,Shafer SL

    更新日期:1993-05-01 00:00:00

  • Effects of combining propofol and alfentanil on ventilation, analgesia, sedation, and emesis in human volunteers.

    abstract:BACKGROUND:Propofol and alfentanil frequently are administered together for intravenous sedation. This study investigated pharmacokinetic and pharmacodynamic interactions between propofol and alfentanil, at sedative concentrations, with specific regard to effects on ventilation, analgesia, sedation, and nausea. METHOD...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Pavlin DJ,Coda B,Shen DD,Tschanz J,Nguyen Q,Schaffer R,Donaldson G,Jacobson RC,Chapman CR

    更新日期:1996-01-01 00:00:00

  • Postoperative bleeding in cardiac surgery: the role of tranexamic acid in patients homozygous for the 5G polymorphism of the plasminogen activator inhibitor-1 gene.

    abstract:BACKGROUND:Plasminogen activator inhibitor 1 (PAI-1) attenuates the conversion of plasminogen to plasmin. Polymorphisms of the PAI-1 gene are associated with varying PAI-1 levels and risk of prothrombotic events in nonsurgical patients. The purpose of this study, a secondary analysis of a clinical trial, was to investi...


    pub_type: 杂志文章


    authors: Iribarren JL,Jimenez JJ,Hernández D,Brouard M,Riverol D,Lorente L,de La Llana R,Nassar I,Perez R,Martinez R,Mora ML

    更新日期:2008-04-01 00:00:00

  • Exogenous ethyl pyruvate versus pyruvate during metabolic recovery after oxidative stress in neonatal rat cerebrocortical slices.

    abstract:BACKGROUND:Exogenous pyruvate and ethyl pyruvate (EP), the key ingredient in a new Ringer's solution in clinical trials, are antioxidants as well as metabolic substrates. In vivo studies show both to be protective in oxidative stress, with EP being better. The authors used an acute rat brain slice preparation to compar...


    pub_type: 杂志文章


    authors: Zeng J,Liu J,Yang GY,Kelly MJ,James TL,Litt L

    更新日期:2007-10-01 00:00:00

  • The American Society of Anesthesiologists Postoperative Visual Loss Registry: analysis of 93 spine surgery cases with postoperative visual loss.

    abstract:BACKGROUND:Postoperative visual loss after prone spine surgery is increasingly reported in association with ischemic optic neuropathy, but its etiology is unknown. METHODS:To describe the clinical characteristics of these patients, the authors analyzed a retrospectively collected series of 93 spine surgery cases volun...


    pub_type: 杂志文章


    authors: Lee LA,Roth S,Posner KL,Cheney FW,Caplan RA,Newman NJ,Domino KB

    更新日期:2006-10-01 00:00:00

  • Preanesthetic medication in children: a comparison of oral transmucosal fentanyl citrate versus placebo.

    abstract::Initial studies have suggested that oral transmucosal fentanyl citrate (OTFC) in a dose of 15-20 micrograms/kg may be a safe and effective preanesthetic medication in children and adults, but this has not been demonstrated in a randomized, double-blind fashion. The purpose of this study was to determine in a randomize...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Feld LH,Champeau MW,van Steennis CA,Scott JC

    更新日期:1989-09-01 00:00:00

  • α2δ-1-Bound N-Methyl-D-aspartate Receptors Mediate Morphine-induced Hyperalgesia and Analgesic Tolerance by Potentiating Glutamatergic Input in Rodents.

    abstract:BACKGROUND:Chronic use of μ-opioid receptor agonists paradoxically causes both hyperalgesia and the loss of analgesic efficacy. Opioid treatment increases presynaptic N-methyl-D-aspartate receptor activity to potentiate nociceptive input to spinal dorsal horn neurons. However, the mechanism responsible for this opioid-...


    pub_type: 杂志文章


    authors: Deng M,Chen SR,Chen H,Pan HL

    更新日期:2019-05-01 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

  • Extubation Success Prediction in a Multicentric Cohort of Patients with Severe Brain Injury.

    abstract:BACKGROUND:Patients with brain injury are at high risk of extubation failure. METHODS:We conducted a prospective observational cohort study in four intensive care units of three university hospitals. The aim of the study was to create a score that could predict extubation success in patients with brain injury. RESULT...


    pub_type: 杂志文章,多中心研究


    authors: Asehnoune K,Seguin P,Lasocki S,Roquilly A,Delater A,Gros A,Denou F,Mahé PJ,Nesseler N,Demeure-Dit-Latte D,Launey Y,Lakhal K,Rozec B,Mallédant Y,Sébille V,Jaber S,Le Thuaut A,Feuillet F,Cinotti R,ATLANREA group.

    更新日期:2017-08-01 00:00:00

  • Effects of the nonimmobilizer hexafluroethane on the model membrane dimyristoylphosphatidylcholine.

    abstract:BACKGROUND:Nonimmobilizers are agents that lack anesthetic properties, although their chemical structure is very similar to known anesthetics. The primary action site of both agents, whether at the membrane or target protein level, is still a matter of debate. However, increasing evidence points to the distinct modific...


    pub_type: 杂志文章


    authors: Koubi L,Tarek M,Bandyopadhyay S,Klein ML,Scharf D

    更新日期:2002-10-01 00:00:00

  • Povidone iodine and skin disinfection before initiation of epidural anesthesia.

    abstract:BACKGROUND:Povidone iodine (PI) solution is used commonly for skin disinfection before epidural and spinal anesthesia. Although there have been reports indicating the presence of microbial contaminants in PI solution, none have evaluated the prevalence of PI contamination. The aims of this study were to assess the freq...


    pub_type: 杂志文章


    authors: Birnbach DJ,Stein DJ,Murray O,Thys DM,Sordillo EM

    更新日期:1998-03-01 00:00:00

  • Isoflurane modulation of neuronal nicotinic acetylcholine receptors expressed in human embryonic kidney cells.

    abstract:BACKGROUND:It is well established that neuronal nicotinic acetylcholine receptors (nAChRs) are sensitive to inhalational anesthetics. The authors previously reported that halothane potently blocked alpha4beta2-type nAChRs of rat cortical neurons. However, the effect of isoflurane, which is widely used clinically, on nA...


    pub_type: 杂志文章


    authors: Yamashita M,Mori T,Nagata K,Yeh JZ,Narahashi T

    更新日期:2005-01-01 00:00:00

  • Pain Management Modalities after Total Knee Arthroplasty: A Network Meta-analysis of 170 Randomized Controlled Trials.

    abstract:BACKGROUND:Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the effic...


    pub_type: 杂志文章,meta分析


    authors: Terkawi AS,Mavridis D,Sessler DI,Nunemaker MS,Doais KS,Terkawi RS,Terkawi YS,Petropoulou M,Nemergut EC

    更新日期:2017-05-01 00:00:00

  • Comparative hemodynamic depression of sevoflurane versus halothane in infants: an echocardiographic study.

    abstract:BACKGROUND:The cardiovascular side effects of volatile anesthetics are one of the chief causes of postoperative complications in children, and infants seem to be at the greatest risk for this. This study compared cardiovascular changes at equipotent concentrations of sevoflurane and halothane in infants. METHODS:Thirt...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Wodey E,Pladys P,Copin C,Lucas MM,Chaumont A,Carre P,Lelong B,Azzis O,Ecoffey C

    更新日期:1997-10-01 00:00:00

  • Dose-independent pharmacokinetics of fentanyl.

    abstract::Fentanyl is used as an analgesic in small doses (1-2 micrograms X kg-1) and as an anesthetic in very large doses (greater than 150 micrograms X kg-1). It has been demonstrated that the effects of fentanyl correlate with its concentrations in plasma. It is important, therefore, to know whether or not the pharmacokineti...


    pub_type: 杂志文章


    authors: Murphy MR,Hug CC Jr,McClain DA

    更新日期:1983-12-01 00:00:00

  • Propofol: relation between brain concentrations, electroencephalogram, middle cerebral artery blood flow velocity, and cerebral oxygen extraction during induction of anesthesia.

    abstract:BACKGROUND:The potential benefit of propofol dose regimens that use physiologic pharmacokinetic modeling to target the brain has been demonstrated in animals, but no data are available on the rate of propofol distribution to the brain in humans. This study measured the brain uptake of propofol in humans and the simulta...


    pub_type: 临床试验,杂志文章


    authors: Ludbrook GL,Visco E,Lam AM

    更新日期:2002-12-01 00:00:00

  • Interaction of neuromuscular blocking effects of neomycin and polymyxin B.

    abstract::Neomycin and polymyxin B produce neuromuscular blocks with distinct features by different mechanisms of action. In eight anesthetized cats the authors studied their interaction by examining the neuromuscular block produced by an equipotent mixture. Values of onset, potency, dose-response relations, duration and revers...


    pub_type: 杂志文章


    authors: Lee C,de Silva AJ

    更新日期:1979-03-01 00:00:00