Abstract:
BACKGROUND:The synergistic effect of clonidine with bupivacaine, well established in peripheral nerve blocks, remains controversial in local field block for postoperative analgesia. OBJECTIVE:To investigate the potential analgesic benefit of adding clonidine to bupivacaine during preincisional field block in posterior approaches for spine surgeries. METHODS:Two hundred twenty-five patients were enrolled in this study and underwent lumbar spinal fusion (n = 80), lumbar laminectomy (n = 25), lumbar microdiscectomy (n = 94), or cervical laminectomy (n = 26). In each surgical subgroup, patients were randomly assigned in a double-blinded fashion to receive either 20 mL of 0.25% bupivacaine alone (control group, n = 109) or with 150 μg clonidine (clonidine group, n = 116) in the form of a preincisional field block. Outcome parameters included area under the curve of pain from postoperative day D0 to D8 and rescue morphine consumption from D0 to D3. RESULTS:The area under the curve was reduced in the clonidine group, particularly in the microdiscectomy subgroup, and without reaching statistical significance in the cervical laminectomy subgroup. Total rescue morphine consumption was reduced in the clonidine group, particularly at D1-D2, a benefit that was exclusive to the lumbar stenosis and lumbar fusion subgroups. Field block with clonidine, surgical subgroup, and the presence of preoperative spinal pain were factors independently influencing postoperative wound pain in multivariate analysis. CONCLUSION:The addition of clonidine to local preincisional field block with bupivacaine resulted in better and prolonged postoperative analgesia in posterior lumbar spine surgeries, an effect that was more pronounced in patients with no preoperative spinal pain.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Abdel Hay J,Kobaiter-Maarrawi S,Tabet P,Moussa R,Rizk T,Nohra G,Okais N,Samaha E,Maarrawi Jdoi
10.1093/neuros/nyx313subject
Has Abstractpub_date
2018-06-01 00:00:00pages
790-798issue
6eissn
0148-396Xissn
1524-4040pii
3988105journal_volume
82pub_type
杂志文章,随机对照试验相关文献
NEUROSURGERY文献大全abstract:BACKGROUND:Neurosurgical emergencies are an important cause of disability and mortality. OBJECTIVE:To examine the nationwide burden of neurological conditions requiring emergency neurosurgery. METHODS:The Nationwide Inpatient Sample database (2002-2011) was queried to identify adult patients with a primary discharge ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyx055
更新日期:2017-09-01 00:00:00
abstract::Premature closure of the metopic suture results in a deformity ranging from a minor variation to a severe cosmetic deformity. The three principal abnormalities comprising metopic synostosis are trigonocephaly secondary to the restriction of growth of both frontal bones, deficient lateral supraorbital rims, and hypotel...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198608000-00008
更新日期:1986-08-01 00:00:00
abstract::The authors describe the technique of magnetic stimulation from a pulsed induction coil (4.0 T) and the enhanced (5-fold) electromyogram response from hyperthenar muscles obtained when electric and magnetic stimuli are applied simultaneously. The enhancement results have been confirmed for central brain vertex stimula...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-198701000-00025
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Stereotactic radiosurgery (SRS) is an effective option in the management of brain metastases, offering improved overall survival to whole-brain radiation therapy (WBRT). However, given the need for active surveillance and the possibility of repeated interventions for local/distant brain recurrences, the bala...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa075
更新日期:2020-09-01 00:00:00
abstract::The effect of altering the volume and timing of hemorrhage on the severity of spasm was studied in a canine model. All animals received three cisterna magna injections of fresh unheparinized autologous arterial blood. Selective left vertebral arteriograms were obtained during the week before and exactly 7 days after t...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198601000-00001
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Intracranial germinomas often disseminate via the ventricular and subarachnoid pathways, but seeding to the perioptic arachnoid space is extremely unusual. We report two cases of recurrent germinoma seeding in the optic nerve. CLINICAL PRESENTATION:Two men with pure germinoma were initially tr...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-200101000-00041
更新日期:2001-01-01 00:00:00
abstract::The authors present a case of acute aggravation of subdural effusion associated with pachymeningitis carcinomatosa. Microscopic examination of a surgical specimen revealed diffuse involvement of the dura mater by a metastatic adenocarcinoma in which the tumor cells invaded venules located in the areolar layer in parti...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199109000-00025
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Cranial pachymeningitis is a typically diffuse granulomatous disease, which often affects the tentorium and falx. We report a rare case of idiopathic cranial pachymeningoencephalitis focally affecting only the left parietal dura mater and adjacent inferior parietal lobule. CLINICAL PRESENTATIO...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199704000-00037
更新日期:1997-04-01 00:00:00
abstract::We undertook a prospective study of 43 wrists in 32 patients who had been clinically diagnosed as having carpal tunnel syndrome (study group) and 5 wrists in people who had no symptoms (control group), correlating the clinical, electrodiagnostic, intraoperative, and magnetic resonance imaging (MRI) findings. MRI of th...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199512000-00009
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Four rare cases of central nervous system solitary fibrous tumors (C-SoFTs) are described. This tumor has not previously been reported in children or in deep cortical structures. Three of these tumors occurred in the posterior fossa. Only four cases in the posterior fossa have been described pr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000115675.74366.87
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Pharmacological prophylaxis for venous thromboembolism (VTE) in the neurosurgical population is still a matter of debate, as the risk-to-benefit ratio is not well defined. OBJECTIVE:To further evaluate the risk-to-benefit ratio of VTE prophylaxis (VTEP) for all neurosurgical procedures. METHODS:A prospecti...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyy035
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:Socioeconomic changes have imposed many administrative demands on neurosurgeons, including managing facilities such as the intensive care unit without absolute authority and maintaining referrals, marketing in an increasingly competitive environment, effecting change within stubborn hospital systems, negotiat...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000318180.80040.d0
更新日期:2008-04-01 00:00:00
abstract::The surgical approaches to the cavernous sinus were examined in 50 adult cadaveric cavernous sinuses using magnification of X3 to X40. The following approaches were examined: 1) the superior intradural approach directed through a frontotemporal craniotomy and the roof of the cavernous sinus; 2) the superior intradural...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199006000-00001
更新日期:1990-06-01 00:00:00
abstract::Irrigation bipolar systems are particularly useful for the washout of hematomas in subarachnoid hemorrhage during the acute stage of surgery and for preventing adherence of tissue to the bipolar tips during coagulation. These systems have become essential tools, and numerous improvements have been made to them. First,...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199606000-00044
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Minimally invasive surgery procedures, including stereotactic catheter aspiration and clearance of intracerebral hemorrhage (ICH) with recombinant tissue plasminogen activator hold a promise to improve outcome of supratentorial brain hemorrhage, a morbid and disabling type of stroke. A recently completed Pha...
journal_title:Neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1093/neuros/nyz077
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To describe the incidence and causes of pediatric head, spinal cord, and peripheral nerve injuries in an urban setting and to assess the implications of these data for injury prevention programs. METHODS:Pediatric deaths and hospital admissions secondary to neurological trauma included in the Northern Manhat...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199802000-00052
更新日期:1998-02-01 00:00:00
abstract::The phosphorylation of an M(r) 20,000 myosin light chain (MLC20) promotes the generation of contractile force through actin-myosin adenosine triphosphatase in most agonist-mediated vascular smooth muscle cell contraction. However, the role of calcium-mediated contractile processes in sustained arterial narrowing after...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199506000-00018
更新日期:1995-06-01 00:00:00
abstract:BACKGROUND:Deep brain stimulation (DBS) is commonly used in the treatment of movement disorders such as Parkinson disease (PD), dystonia, and other tremors. OBJECTIVE:To examine systematic errors in image-guided DBS electrode placement and to explore a calibration strategy for stereotactic targeting. METHODS:Pre- and...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e3181f7422a
更新日期:2010-12-01 00:00:00
abstract::The authors report a case of cranial plasmacytoma with multiple myelomas and palsy of the lower cranial nerves. The osteolytic lesion adjacent to the jugular foramen was demonstrated by an angiogram to be exceedingly hypervascular, with arteriovenous shunting resembling that seen in paragangliomas. Forty-five cases of...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199012000-00018
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVE:The most common postoperative complication of the transsphenoidal approach is cerebrospinal fluid (CSF) rhinorrhea. If the dura is widely opened beyond the sellar floor and massive intraoperative CSF leakage is encountered, then the conventional packing method, in which the sella turcica is filled with pieces...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000108780.72365.dc
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:We report the design and initial characterization of the dosimetry and radiobiology of a novel device for interstitial stereotactic radiosurgery. INSTRUMENTATION:The device is lightweight, handheld, and battery-powered, and it emits x-ray radiation from the tip of a probe 3 mm in diameter by 10 cm in length....
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199703000-00016
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Cavity stereotactic radiotherapy has emerged as a standard option following resection of brain metastases. However, the optimal approach with either single-fraction or hypofractionated stereotactic radiotherapy (HSRT) remains a significant question. OBJECTIVE:To report outcomes for 5-fraction HSRT to the su...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyz162
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:We present our microsurgical lateral orbital approach for intraorbital lesions, with special emphasis on the microanatomy of the orbit. METHODS:Among 26 patients, such lesions included tumors of the lacrimal glands, cavernous angioma, meningioma, neuroma, and other tumors. These intraorbital lesions were rem...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199612000-00018
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Endovascular treatment of wide-necked and complex aneurysms may require stent-assisted coiling, either as primary stenting or combined with the balloon remodeling technique (BRT). OBJECTIVE:To compare the angiographic results and clinical outcomes of both strategies in the Safety and Efficacy of Neuroform f...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000000639
更新日期:2015-04-01 00:00:00
abstract::The scope and purpose of this work is 2-fold: to synthesize the available evidence and to translate it into recommendations. This document provides recommendations only when there is evidence to support them. As such, they do not constitute a complete protocol for clinical use. Our intention is that these recommendati...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0000000000001432
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:Stereotactic radiosurgery is being used with more frequency in the management of patients with trigeminal neuralgia. To improve facial pain outcomes, many centers have increased the prescribed radiation dose to the trigeminal nerve. METHODS:Between April 1997 and December 1999, 68 patients underwent radiosur...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200107000-00008
更新日期:2001-07-01 00:00:00
abstract:INTRODUCTION:We evaluated the feasibility, usefulness, and limitations of near-infrared indocyanine green (ICG) videoangiography during procedures involving the extracranial vertebral artery (VA). METHODS:Nine patients (2 women, 7 men; mean age, 55 years) were evaluated at 2 neurosurgical centers. Near-infrared ICG vi...
journal_title:Neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1227/01.NEU.0000363596.52283.65
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Intraoperative neurophysiological monitoring, including upper- and lower-extremity somatosensory evoked potentials (SSEPs), has been used to identify and prevent injury to neurovascular structures during conventional skull base surgery. The expanded endonasal approach (EEA) is a novel minimally invasive appr...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31821606e4
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Fifty percent of implanted cerebrospinal fluid (CSF) shunts fail within 2 years, primarily because of obstruction of the proximal catheter. Percutaneous techniques to reduce the morbidity of shunt revision are being developed. The authors describe the development of a device that uses ultrasonic cavitation to...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000233968.80352.25
更新日期:2006-10-01 00:00:00
abstract::Twenty-seven newborn infants (birth weight, 1503 +/- 776 g; gestational age, 31 +/- 3 wk) (mean +/- standard deviation) with rapidly progressive posthemorrhagic hydrocephalus and increased intracranial pressure were treated by external ventricular drainage. The progression of hydrocephalus was arrested during the drai...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199207000-00008
更新日期:1992-07-01 00:00:00