Identification of the correct cervical level by palpation of spinous processes.

Abstract:

BACKGROUND:The ability to identify the correct vertebral level through examination is an important skill for clinicians who are performing nerve blocks without fluoroscopy. The conventional palpation method, which identifies the most prominent cervical spinous process as the seventh cervical (C7) spinous process is unreliable in many cases. We compared the accuracy of 2 different palpation methods used for identifying C7. METHODS:Ninety-six patients scheduled for cervical spine procedures under fluoroscopy guidance were randomized into either the control group or the flexion-extension group. The control group was examined with the conventional method, and the flexion-extension group was examined through assisted flexion and extension of the patient's cervical spine and identifying the lowest freely moving spinous process as C6 and the following stationary cervical spinous process as C7. A single anesthesiologist attempted to identify the C7 spinous process by using either the conventional method or the flexion-extension method and marked the presumed C7 spinous process with a radiopaque indicator. The actual vertebral level was then confirmed by fluoroscopy. The accuracy of the 2 different palpation techniques was compared, and the influence of patients' age, gender, and body mass index (BMI) was also examined. RESULTS:The C7 spinous process was correctly identified in 77.1% of patients in the flexion-extension group, compared with 37.5% in the control group (P<0.001). The C6 spinous process was identified as the most prominent cervical spinous process instead of C7 in 47.9% of patients in the control group, showing that errors are more common in the cephalad direction with the conventional method. The accuracy of the flexion-extension method was significantly higher than the conventional method regardless of the patient's age, gender, and BMI. Particularly, this difference in accuracy was seen not only in patients with a BMI <25 kg/m(2), but also in those with a BMI ≥25 kg/m(2) (BMI <25 kg/m(2), P=0.006 vs BMI ≥25 kg/m(2), P=0.008). CONCLUSIONS:The flexion-extension method is more accurate than the conventional method when identifying cervical vertebral level.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Shin S,Yoon DM,Yoon KB

doi

10.1213/ANE.0b013e3182110f9f

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

1232-5

issue

5

eissn

0003-2999

issn

1526-7598

pii

ANE.0b013e3182110f9f

journal_volume

112

pub_type

杂志文章,随机对照试验
  • The differential effects of midazolam and diazepam on intracellular Ca2+ transients and contraction in adult rat ventricular myocytes.

    abstract:UNLABELLED:We investigated the direct effects of midazolam and diazepam on cardiac excitation-contraction coupling in adult rat ventricular myocytes. Freshly isolated rat ventricular myocytes were loaded with fura-2/AM and field-stimulated at 28 degrees C. Intracellular Ca(2+) transients (340:380 ratio) and myocyte sho...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200212000-00030

    authors: Kanaya N,Murray PA,Damron DS

    更新日期:2002-12-01 00:00:00

  • Nitric oxide synthesis inhibition modifies the cardiotoxicity of tetracaine and lidocaine.

    abstract:UNLABELLED:Suppression of nitric oxide (NO) production alters the toxicity of cocaine and bupivacaine. We undertook this study to determine whether the systemic toxicity of two other local anesthetics that differ in antiarrhythmic activity, plasma clearance, and biotransformation are similarly affected by nitric oxide ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199904000-00003

    authors: Heavner JE,Shi B,Pitkänen M

    更新日期:1999-04-01 00:00:00

  • An assessment of the antinociceptive efficacy of intrathecal and epidural contulakin-G in rats and dogs.

    abstract::Contulakin-G is a novel conopeptide with an incompletely defined mechanism of action. To assess nociceptive activity we delivered Contulakin-G as a bolus intrathecally (0.03, 0.1, 0.3, 3 nmol) or epidurally (10, 30, 89 nmol) in rats. Intrathecal Contulakin G significantly decreased Phase II and, to a lesser degree, Ph...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000219586.65112.FA

    authors: Allen JW,Hofer K,McCumber D,Wagstaff JD,Layer RT,McCabe RT,Yaksh TL

    更新日期:2007-06-01 00:00:00

  • The inhibition of epidural morphine-induced pruritus by epidural droperidol.

    abstract:UNLABELLED:IV droperidol inhibits epidural morphine-induced pruritus, but this effect disappears when the dose is increased from 2.5 to 5.0 mg. This study was performed to determine whether epidural droperidol would have a similar effect. In this double-blinded study, we enrolled 140 patients undergoing Cesarean delive...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200003000-00025

    authors: Horta ML,Ramos L,Gonçalves ZR

    更新日期:2000-03-01 00:00:00

  • Effects of 6% hydroxyethyl starch and 3% modified fluid gelatin on intravascular volume and coagulation during intraoperative hemodilution.

    abstract::In the perioperative period, artificial colloids are most often infused in doses of 500-1000 mL intravenously. This randomized study compared the effects on intravascular volume and coagulation of approximately 2000 mL of two isooncotic artificial colloids: 6% hydroxyethyl starch (HES; MW 200,000; substitution ratio 0...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199512000-00020

    authors: Mortelmans YJ,Vermaut G,Verbruggen AM,Arnout JM,Vermylen J,Van Aken H,Mortelmans LA

    更新日期:1995-12-01 00:00:00

  • Differential opioid inhibition of C- and A delta- fiber mediated thermonociception after stimulation of the nucleus raphe magnus.

    abstract:UNLABELLED:Although the importance of the nucleus raphe magnus in descending inhibitory control of nociception is clear, it is not known whether these effects are equivalent for different types of nociception. Thus, we examined the differential inhibition of behavioral responses evoked by A delta or C fiber thermonocic...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000094334.12027.06

    authors: Lu Y,Sweitzer SM,Laurito CE,Yeomans DC

    更新日期:2004-02-01 00:00:00

  • Effect of cardiopulmonary bypass on plasma levels of nifedipine.

    abstract::Blood levels of many medications are acutely lowered by cardiopulmonary bypass (CPB). Because nifedipine is often used to provide protection from coronary ischemia, a determination of the effect of CPB on plasma nifedipine levels might help to determine the potential clinical benefit of nifedipine during and after byp...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-199010000-00016

    authors: Katz RI,Kanchuger MS,Patton KF,Eide TR

    更新日期:1990-10-01 00:00:00

  • Excessive postoperative bleeding and outcomes in neonates undergoing cardiopulmonary bypass.

    abstract:BACKGROUND:Neonates undergoing cardiac surgery are especially prone to the hemostatic alterations of cardiopulmonary bypass (CPB) and are at high risk for post-CPB bleeding. An immature coagulation system, significant hemodilution from the CPB prime, long CPB times at low temperatures, and extensive suture lines increa...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000531

    authors: Guzzetta NA,Allen NN,Wilson EC,Foster GS,Ehrlich AC,Miller BE

    更新日期:2015-02-01 00:00:00

  • Mivacurium and bronchospasm.

    abstract:IMPLICATIONS:Because of case reports of severe bronchospasm after the use of mivacurium, we used the Food and Drug Administration MedWatch database to determine the frequency of bronchospasm as an adverse event after the use of nondepolarizing muscle relaxants. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000067433.05538.3d

    authors: Bishop MJ,O'Donnell JT,Salemi JR

    更新日期:2003-08-01 00:00:00

  • Use of cognitive aids in a simulated anesthetic crisis.

    abstract::We evaluated empirically the extent to which the use of a cognitive aid during a high-fidelity simulation of a malignant hyperthermia (MH) event facilitated the correct and prompt treatment of MH. We reviewed the management of 48 simulated adult MH scenarios; 24 involving CA 1 and 24 involving CA 2 residents. In the C...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000229718.02478.c4

    authors: Harrison TK,Manser T,Howard SK,Gaba DM

    更新日期:2006-09-01 00:00:00

  • Special article: mandragora: anesthetic of the ancients.

    abstract::Initial attempts at surgical anesthesia began many centuries ago, with the plants of antiquity. The mandragora, or mandrake, was used as a sedative and to induce pain relief for surgical procedures. It has been depicted in tablets and friezes since the 16th century before the common era (BCE) and used for its sedative...

    journal_title:Anesthesia and analgesia

    pub_type: 历史文章,杂志文章,评审

    doi:10.1213/ANE.0b013e318259ee4d

    authors: Chidiac EJ,Kaddoum RN,Fuleihan SF

    更新日期:2012-12-01 00:00:00

  • The impact of business cards on physician recognition after general anesthesia.

    abstract:UNLABELLED:Despite their contribution to overall perioperative treatment of patients, anesthesiologists often remain in anonymity. We evaluated the impact of business cards on physician recognition after general anesthesia. Using a questionnaire, 441 patients were interviewed for recall of the anesthesiologist's name, ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200111000-00045

    authors: Jeske HC,Lederer W,Lorenz I,Kolbitsch C,Margreiter J,Kinzl J,Benzer A

    更新日期:2001-11-01 00:00:00

  • Epinephrine injection in lipid-based resuscitation from bupivacaine-induced cardiac arrest: transient circulatory return in rabbits.

    abstract:BACKGROUND:IV lipid emulsion has demonstrated to be effective therapy for bupivacaine-induced cardiotoxicity. However, the role of epinephrine when coadministered with lipid emulsion in toxin-induced cardiac arrest is unclear. We postulated superior resuscitation outcome in the absence of epinephrine in a rabbit model ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181e66050

    authors: Harvey M,Cave G,Prince G,Lahner D

    更新日期:2010-09-01 00:00:00

  • Hemodynamic and cardiodynamic effects of propofol and etomidate: negative inotropic properties of propofol.

    abstract::The hemodynamic effects of an induction dose of propofol, 2.5 mg/kg, or etomidate, 0.3 mg/kg, were studied in eight dogs. In addition, cardiodynamic changes were measured using a left ventricular catheter and needle force probes. Propofol was associated with significant decreases in systolic (19.9%) and diastolic (25....

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Brüssel T,Theissen JL,Vigfusson G,Lunkenheimer PP,Van Aken H,Lawin P

    更新日期:1989-07-01 00:00:00

  • Hepatic circulation during surgical stress and anesthesia with halothane, isoflurane, or fentanyl.

    abstract::Hepatic blood flow and the oxygen supply/uptake relation were studied in 19 miniature pigs using labeled microspheres. Changes in hepatic arterial blood flow and portal blood flow, as well as total hepatic blood flow during halothane anesthesia were more closely associated with changes in mean arterial pressure (MAP) ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Gelman S,Dillard E,Bradley EL Jr

    更新日期:1987-10-01 00:00:00

  • World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia.

    abstract::The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a nonprofit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000002927

    authors: Gelb AW,Morriss WW,Johnson W,Merry AF,Abayadeera A,Belîi N,Brull SJ,Chibana A,Evans F,Goddia C,Haylock-Loor C,Khan F,Leal S,Lin N,Merchant R,Newton MW,Rowles JS,Sanusi A,Wilson I,Velazquez Berumen A,International

    更新日期:2018-06-01 00:00:00

  • A comparison of the volume and pH of gastric contents of obese and lean surgical patients.

    abstract:UNLABELLED:Obese surgical patients are typically considered to be more likely than lean patients to possess high-volume and low-pH (HVLP) gastric contents after a standard preoperative fast, based on a study of a population predominately consisting of patients receiving intramuscular preoperative sedation. We revisited...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199801000-00030

    authors: Harter RL,Kelly WB,Kramer MG,Perez CE,Dzwonczyk RR

    更新日期:1998-01-01 00:00:00

  • Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial.

    abstract:BACKGROUND:In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000003315

    authors: Shin HJ,Do SH,Lee JS,Kim TK,Na HS

    更新日期:2019-12-01 00:00:00

  • Preanesthetic evaluation and management of malignant hyperthermia in the pig experimental model.

    abstract::Fifty-three swine from the University of Missouri Sinclair Medical Research Farm were used in experimentation to determine their susceptibility to malignant hyperthermia, to determine appropriate anesthetic agents for susceptible swine and to investigate appropriate pharmaceutical agents which could protect against th...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197609000-00007

    authors: Short CE,Paddleford RR,McGrath CJ,Williams CH

    更新日期:1976-09-01 00:00:00

  • Systemic mexiletine relieves chronic allodynialike symptoms in rats with ischemic spinal cord injury.

    abstract::We have recently reported a chronic allodynialike symptom in rats after ischemic spinal cord injury. This pain-related behavior is resistant to a number of pharmacologic treatments, including morphine, clonidine, carbamazepine, baclofen, and muscimol. In the present report, we present evidence indicating that systemic...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199205000-00005

    authors: Xu XJ,Hao JX,Seiger A,Arnér S,Lindblom U,Wiesenfeld-Hallin Z

    更新日期:1992-05-01 00:00:00

  • Descriptive Statistics: Reporting the Answers to the 5 Basic Questions of Who, What, Why, When, Where, and a Sixth, So What?

    abstract::Descriptive statistics are specific methods basically used to calculate, describe, and summarize collected research data in a logical, meaningful, and efficient way. Descriptive statistics are reported numerically in the manuscript text and/or in its tables, or graphically in its figures. This basic statistical tutori...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000002471

    authors: Vetter TR

    更新日期:2017-11-01 00:00:00

  • Is There Evidence for Systematic Upcoding of ASA Physical Status Coincident with Payer Incentives? A Regression Discontinuity Analysis of the National Anesthesia Clinical Outcomes Registry.

    abstract:BACKGROUND:Modifications in physician billing patterns have been shown to occur in response to payer incentives, but the phenomenon remains largely unexplored in billing for anesthesia services. Within the field of anesthesiology, Medicare's policy not to provide additional reimbursement for higher ASA physical status ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000917

    authors: Schonberger RB,Dutton RP,Dai F

    更新日期:2016-01-01 00:00:00

  • Hematocrit and the solubility of volatile anesthetics in blood.

    abstract::To clarify the effect of hematocrit on the solubility of volatile anesthetics in blood, we measured the blood-gas partition coefficients of isoflurane, enflurane, halothane, and methoxyflurane concurrently at 37 degrees C in blood from four adults. We measured the blood-gas partition coefficients in the plasma (hemato...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Lerman J,Gregory GA,Eger EI 2nd

    更新日期:1984-10-01 00:00:00

  • A comparison of lidocaine and bupivacaine digital nerve blocks on noninvasive continuous hemoglobin monitoring in a randomized trial in volunteers.

    abstract:BACKGROUND:Blood hemoglobin can be monitored continuously and noninvasively with a noninvasive spectrophotometric sensor (Masimo SpHb). The perfusion index (PI) of the finger is directly related to the clinical accuracy of SpHb. We evaluated those variables that influence PI without the influences of surgery and anesth...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000000144

    authors: Miller RD,Ward TA,McCulloch CE,Cohen NH

    更新日期:2014-04-01 00:00:00

  • Preoperative sciatic nerve block decreases mechanical allodynia more in young rats: is preemptive analgesia developmentally modulated?

    abstract::Postoperative sensitivity to tactile stimuli differs as a function of age. In this study, we hypothesized that preoperative sciatic nerve block (SNB), by providing preemptive analgesia, would result in better analgesia than postoperative SNB in the young rat. With the paw incision model of postoperative pain, male Spr...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000114181.69204.72

    authors: Ririe DG,Barclay D,Prout H,Tong C,Tobin JR,Eisenach JC

    更新日期:2004-07-01 00:00:00

  • Ultrasound-guided epidural catheter insertion in children.

    abstract:UNLABELLED:Epidural catheters (EC) are often used in pediatric patients for intraoperative and postoperative pain relief. The small anatomical structures and catheter insertion under general anesthesia make it more difficult to perform EC and to prevent damage. In this study we investigated the use of ultrasound (US) i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000156579.11254.D1

    authors: Rapp HJ,Folger A,Grau T

    更新日期:2005-08-01 00:00:00

  • Ethanol enhances the functional recovery of stunned myocardium independent of K(ATP) channels in dogs.

    abstract::Chronic, intermittent exposure to small amounts of ethanol reduces myocardial infarct size in vivo. We tested the hypothesis that acute administration of ethanol enhances the functional recovery of stunned myocardium and that adenosine triphosphate-dependent potassium (K(ATP)) channels mediate this beneficial effect. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200102000-00003

    authors: Gross ER,Gare M,Toller WG,Kersten JR,Warltier DC,Pagel PS

    更新日期:2001-02-01 00:00:00

  • The effects of sevoflurane and hyperventilation on electrocorticogram spike activity in patients with refractory epilepsy.

    abstract:UNLABELLED:We investigated the effects of sevoflurane and hyperventilation on intraoperative electrocorticogram (ECoG) spike activity in 13 patients with intractable epilepsy. Grid electrodes were placed on the brain surface and ECoG was recorded under the following conditions: 1) 0.5 minimal alveolar anesthetic concen...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ANE.0000158606.31021.1F

    authors: Kurita N,Kawaguchi M,Hoshida T,Nakase H,Sakaki T,Furuya H

    更新日期:2005-08-01 00:00:00

  • Orthostatic hypotension during postoperative continuous thoracic epidural bupivacaine-morphine in patients undergoing abdominal surgery.

    abstract::Fifty patients undergoing colonic surgery received combined thoracic epidural and general anesthesia followed by continuous epidural bupivacaine 0.25% and morphine 0.05 mg/mL, 4 mL/h, for 96 h postoperatively plus oral tenoxicam 20 mg daily. Heart rate (HR) and arterial blood pressure (BP) were measured at supine rest...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199611000-00022

    authors: Crawford ME,Møiniche S,Orbaek J,Bjerrum H,Kehlet H

    更新日期:1996-11-01 00:00:00

  • Duration of intrathecal labor analgesia: early versus advanced labor.

    abstract::Early first-stage labor pain is primarily visceral in origin. Increasing pain intensity and transition to somatic nociceptive input characterizes late first- and second-stage labor pain. The effect of this change in nociceptive input on the duration of intrathecal labor analgesia has not been well studied. This prospe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199705000-00028

    authors: Viscomi CM,Rathmell JP,Pace NL

    更新日期:1997-05-01 00:00:00