Postoperative epidural analgesia and oral anticoagulant therapy.


:The relative safety of epidural catheter placement with subsequent heparinization has been well documented. However, what is the risk of neurologic sequelae in such patients who receive warfarin perioperatively? This study retrospectively evaluates the risk of spinal hematoma in patients receiving postoperative epidural analgesia while receiving low-dose warfarin after total knee replacement. All patients received low-dose warfarin to prolong the prothrombin time (PT) to 15.0-17.3 s (normal 10.9-12.8 s). There were 192 epidural catheters placed in 188 patients. All catheters were advanced through an 18-gauge needle. In 13 instances, blood was noted during needle and/or catheter placement. In addition to warfarin, 36 patients with indwelling catheters received nonsteroidal antiinflammatory drugs (NSAIDs). Epidural catheters were left indwelling 37.5 +/- 15 h (range 13-96 h). The mean PT was not increased beyond the normal range until the third postoperative day and did not reach 15 s until the seventh postoperative day. Cumulative warfarin dose at that time was 20.0 +/- 7.6 mg. Mean PT at the time of epidural catheter removal was 13.4 +/- 2 s. There were no signs of spinal hematoma. Although epidural catheter placement and subsequent anticoagulation with warfarin appears relatively safe, there is a large variability in patient response to warfarin; therefore, coagulation status should be monitored to avoid excessive prolongation of the PT, and the patient should be watched closely for evidence of spinal hematoma.


Anesth Analg


Anesthesia and analgesia


Horlocker TT,Wedel DJ,Schlichting JL




Has Abstract


1994-07-01 00:00:00












  • The dose-response of nitrous oxide in postoperative nausea in patients undergoing gynecologic laparoscopic surgery: a preliminary study.

    abstract:BACKGROUND:Whether nitrous oxide (N(2)O) increases the incidence of postoperative nausea and vomiting (PONV) after laparoscopic gynecologic surgery is still controversial, which may be due to the administration of different concentrations of inspired N(2)O. We investigated whether N(2)O results in a dose-response incre...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Mraovic B,Simurina T,Sonicki Z,Skitarelic N,Gan TJ

    更新日期:2008-09-01 00:00:00

  • Bispectral-index-guided versus clinically guided remifentanil/propofol analgesia/sedation for interventional radiological procedures: an observer-blinded randomized study.

    abstract::Patients undergoing potentially painful interventional radiological procedures generally require a combination of analgesia and sedation. This sedation/analgesia should allow the patient to communicate while also remaining calm. Bispectral index (BIS) monitoring could be useful in achieving this. The primary end-point...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Dahaba AA,Lischnig U,Kronthaler R,Bornemann H,Georgiev V,Rehak PH,Metzler H

    更新日期:2006-08-01 00:00:00

  • Pharmacokinetics of fentanyl in neonates.

    abstract::The pharmacokinetics of fentanyl were studied in fourteen neonates undergoing major surgical procedures. Five patients were less than 1 day of age, seven were 1-4 days old, and two were 7-14 days old. Fentanyl was given intravenously, 10 micrograms/kg (n = 1), 25 micrograms/kg (n = 4), or 50 micrograms/kg (n = 9), and...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Koehntop DE,Rodman JH,Brundage DM,Hegland MG,Buckley JJ

    更新日期:1986-03-01 00:00:00

  • Prevention of hypotension after spinal anesthesia for cesarean section: six percent hetastarch versus lactated Ringer's solution.

    abstract::This study was designed to determine whether preoperative administration of 6% hetastarch decreases the incidence and severity of hypotension after spinal anesthesia for cesarean section. Forty nonlaboring ASA class I and II women having nonurgent cesarean sections were randomized to receive either 500 mL of 6% hetast...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Riley ET,Cohen SE,Rubenstein AJ,Flanagan B

    更新日期:1995-10-01 00:00:00

  • Educating Patients Regarding Pain Management and Safe Opioid Use After Surgery: A Narrative Review.

    abstract::In recent years, there have been escalating concerns related to the opioid epidemic. With a steadily increasing opioid supply, it is critical to provide proper education to patients who are prescribed these medications. Education should be emphasized as a means of ensuring safe use and potentially as a strategy for cu...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Lee BH,Wu CL

    更新日期:2020-03-01 00:00:00

  • Minimum alveolar anesthetic concentration of fluorinated alkanols in rats: relevance to theories of narcosis.

    abstract:UNLABELLED:The Meyer-Overton hypothesis predicts that the potency of conventional inhaled anesthetics correlates inversely with lipophilicity: minimum alveolar anesthetic concentration (MAC) x the olive oil/gas partition coefficient equals a constant of approximately 1.82 +/- 0.56 atm (mean +/- SD), whereas MAC x the o...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Eger EI 2nd,Ionescu P,Laster MJ,Gong D,Hudlicky T,Kendig JJ,Harris RA,Trudell JR,Pohorille A

    更新日期:1999-04-01 00:00:00

  • Adenosine triphosphate-sensitive potassium channel blockers attenuate the antiallodynic effect of R-PIA in neuropathic rats.

    abstract:BACKGROUND:Nerve injury can generate neuropathic pain. The accompanying mechanical allodynia may be reduced by the intrathecal administration of adenosine. The neuroprotective effects of adenosine are mediated by the adenosine triphosphate (ATP)-sensitive potassium (K(ATP)) channel. We assessed the relationship between...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Song JG,Hahm KD,Kim YK,Leem JG,Lee C,Jeong SM,Park PH,Shin JW

    更新日期:2011-06-01 00:00:00

  • Effect of isoflurane on neuronal apoptosis in rats subjected to focal cerebral ischemia.

    abstract:UNLABELLED:Although isoflurane can reduce ischemic neuronal injury after short postischemic recovery intervals, this neuroprotective efficacy is not sustained. Neuronal apoptosis can contribute to the gradual increase in infarct size after ischemia. This suggests that isoflurane, although capable of reducing early neur...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Kawaguchi M,Drummond JC,Cole DJ,Kelly PJ,Spurlock MP,Patel PM

    更新日期:2004-03-01 00:00:00

  • Effects of Electrical Transcutaneous Vagus Nerve Stimulation on the Perceived Intensity of Repetitive Painful Heat Stimuli: A Blinded Placebo- and Sham-Controlled Randomized Crossover Investigation.

    abstract:BACKGROUND:Transcutaneous vagus nerve stimulation (TVNS) is a promising treatment for acute and chronic pain. However, experimental studies yielded controversial results. We examined if TVNS reduces the perceived intensity of repetitive painful heat stimulation and temporal summation of pain (TSP) in healthy volunteers...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Janner H,Klausenitz C,Gürtler N,Hahnenkamp K,Usichenko TI

    更新日期:2018-06-01 00:00:00

  • To do or not to do a preinduction check-up of the anesthesia machine.

    abstract::The anesthesia machine check is an integral part of the anesthesiologist's daily routine. It is standard operating procedure to check the high- and low-pressure systems of the machine as well as other integral parts that are accessible. Many new anesthesia machines offer a self-testing capability, but older ones with ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Ianchulev SA,Comunale ME

    更新日期:2005-09-01 00:00:00

  • Verifying correct endotracheal intubation by measurement of end-tidal carbon dioxide during an ex utero intrapartum treatment procedure.

    abstract::The ex utero intrapartum treatment (EXIT) procedure provides time to secure the airway of the fetus while utero-placental circulation supplies the fetus with oxygen. We report the anesthetic management of a fetus with a large neck mass during an EXIT procedure in which the confirmation of correct endotracheal intubati...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Eschertzhuber S,Keller C,Mitterschiffthaler G,Jochberger S,Kühbacher G

    更新日期:2005-09-01 00:00:00

  • Arterial waveform analysis for the anesthesiologist: past, present, and future concepts.

    abstract::Qualitative arterial waveform analysis has been in existence for millennia; quantitative arterial waveform analysis techniques, which can be traced back to Euler's work in the 18th century, have not been widely used by anesthesiologists and other clinicians. This is likely attributable, in part, to the widespread use ...

    journal_title:Anesthesia and analgesia

    pub_type: 历史文章,杂志文章,评审


    authors: Thiele RH,Durieux ME

    更新日期:2011-10-01 00:00:00

  • The pronociceptive effect of ondansetron in the setting of P-glycoprotein inhibition.

    abstract::Ondansetron is a potent antiemetic drug that acts through inhibition of the 5HT3 receptors for serotonin. Minimum alveolar concentration (MAC) for isoflurane is not affected by systemic ondansetron; however ondansetron is a substrate of P-glycoprotein, a transport pump expressed in the blood-brain barrier. Thus, we hy...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Scott JA,Wood M,Flood P

    更新日期:2006-09-01 00:00:00

  • Continuous positive airway pressure versus noninvasive pressure support ventilation to treat atelectasis after cardiac surgery.

    abstract::Atelectasis is common after cardiac surgery and may result in impaired gas exchange. Continuous positive airway pressure (CPAP) is often used to prevent or treat postoperative atelectasis. We hypothesized that noninvasive pressure support ventilation (NIPSV) by increasing tidal volume could improve the evolution of at...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Pasquina P,Merlani P,Granier JM,Ricou B

    更新日期:2004-10-01 00:00:00

  • The recovery profile of baroreflex control of heart rate after isoflurane or sevoflurane anesthesia in humans.

    abstract:UNLABELLED:Volatile anesthetics attenuate baroreflex function in a concentration-dependent manner. This study was designed to determine how long full recovery of baroreflex control of heart rate takes after isoflurane or sevoflurane anesthesia in healthy volunteers. We assessed baroreflex sensitivity in 20 subjects ran...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Nagasaki G,Tanaka M,Nishikawa T

    更新日期:2001-11-01 00:00:00

  • Holiday and weekend operating room on-call staffing requirements.

    abstract:BACKGROUND:Every facility that performs cases on holidays has in some way decided on its operating room (OR) and anesthesia staffing for holidays. Previous studies have not examined how best to calculate appropriate holiday staffing. METHODS:We analyzed weekend and holiday data from a university hospital. RESULTS:The...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Dexter F,Epstein RH

    更新日期:2006-12-01 00:00:00

  • The Mechanism of Mitral Regurgitation Influences the Temporal Dynamics of the Vena Contracta Area as Measured with Color Flow Doppler.

    abstract:BACKGROUND:In patients with mitral regurgitation (MR), the effective regurgitant orifice area can be estimated by measuring the vena contracta area (VCA). We hypothesize that the VCA has characteristic temporal dynamics related to the underlying mechanism of functional mitral regurgitation (FMR) versus degenerative mit...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Cobey FC,Ashihkmina E,Edrich T,Fox J,Shook D,Bollen B,Breeze JL,Ursprung WW,Shernan SK

    更新日期:2016-02-01 00:00:00

  • In vitro anesthetic washin and washout via bubble oxygenators: influence of anesthetic solubility and rates of carrier gas inflow and pump blood flow.

    abstract::The uptake and elimination of volatile anesthetic agents administered to patients under conditions of hemodilution and hypothermia during cardiopulmonary bypass have not been determined. To define the limitations imposed by oxygenators, we defined washin and washout curves for volatile anesthetic agents administered t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Nussmeier NA,Moskowitz GJ,Weiskopf RB,Cohen NH,Fisher DM,Eger EI 2nd

    更新日期:1988-10-01 00:00:00

  • Fluid resuscitation with 6% hydroxyethyl starch (130/0.4) in acutely ill patients: an updated systematic review and meta-analysis.

    abstract:BACKGROUND:Recent research suggests that 6% hydroxyethyl starch (HES) 130/0.4 is one of the most frequently used resuscitation fluids worldwide. The retraction of studies evaluating its use necessitates a reevaluation of available evidence regarding its safety and efficacy. METHODS:We performed a systematic review and...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析,评审


    authors: Gattas DJ,Dan A,Myburgh J,Billot L,Lo S,Finfer S,CHEST Management Committee.

    更新日期:2012-01-01 00:00:00

  • Antinociceptive potentiation and attenuation of tolerance by intrathecal co-infusion of magnesium sulfate and morphine in rats.

    abstract:UNLABELLED:N-methyl-D-aspartate (NMDA) antagonists, such as MK801, delay the development of morphine tolerance. Magnesium, a noncompetitive NMDA antagonist, reduces postoperative morphine requirements. The present study was designed to evaluate the effects of intrathecal co-administration of magnesium sulfate with morp...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: McCarthy RJ,Kroin JS,Tuman KJ,Penn RD,Ivankovich AD

    更新日期:1998-04-01 00:00:00

  • The population problem: conceptions and misconceptions.

    abstract::Only 1 in about 110 sex acts results in a conception and 1 in 270 in a live birth. Of all conceptions, 40% result in live births, 5% in stillbirths, and 55% never develop. 1/3 of all known conceptions ends in abortion, spontaneous or induced. It appears that the population problem depends on a small fraction of the...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Berelson B

    更新日期:1971-07-01 00:00:00

  • 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 unr...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Shin S,Yoon DM,Yoon KB

    更新日期:2011-05-01 00:00:00

  • Perioperative Lung Protection: Clinical Implications.

    abstract::In the past, it was common practice to use a high tidal volume (VT) during intraoperative ventilation, because this reduced the need for high oxygen fractions to compensate for the ventilation-perfusion mismatches due to atelectasis in a time when it was uncommon to use positive end-expiratory pressure (PEEP) in the o...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Hol L,Nijbroek SGLH,Schultz MJ

    更新日期:2020-12-01 00:00:00

  • Regional anesthesia in children.

    abstract::Regional anesthesia employing the spinal, epidural, or caudal approach was used to anesthetize 200 children, varying in age from 17 days to 15 years. Lidocaine in concentrations varying according to age was used. Ketamine (1 to 2 mg./kg.) was given in the majority of cases to ensure a quiet patient prior to block. No ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Melman E,Penuelas JA,Marrufo J

    更新日期:1975-05-01 00:00:00

  • Differences in production of reactive oxygen species and mitochondrial uncoupling as events in the preconditioning signaling cascade between desflurane and sevoflurane.

    abstract:BACKGROUND:Signal transduction cascade of anesthetic-induced preconditioning has been extensively studied, yet many aspects of it remain unsolved. Here, we investigated the roles of reactive oxygen species (ROS) and mitochondrial uncoupling in cardiomyocyte preconditioning by two modern volatile anesthetics: desflurane...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Sedlic F,Pravdic D,Ljubkovic M,Marinovic J,Stadnicka A,Bosnjak ZJ

    更新日期:2009-08-01 00:00:00

  • Is oral clonidine effective in modifying the acute hemodynamic response during electroconvulsive therapy?

    abstract:UNLABELLED:Clonidine decreases the stress-induced sympathoadrenal responses to painful stimuli and improves hemodynamic stability during general anesthesia. Because acute hypertensive responses are often observed immediately after electroconvulsive therapy (ECT), we designed a prospective, randomized, placebo-controlle...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Fu W,Stool LA,White PF,Husain MM

    更新日期:1998-05-01 00:00:00

  • Neuromuscular effects of succinylcholine on the vocal cords and adductor pollicis muscles.

    abstract::To quantify the effects of succinylcholine at the laryngeal adductor muscles and the adductor pollicis, 17 adult patients were studied during propofol-fentanyl anesthesia. Train-of-four stimulation was applied to the ulnar nerve at the wrist and the recurrent laryngeal nerve at the notch of the thyroid cartilage. Lary...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Meistelman C,Plaud B,Donati F

    更新日期:1991-09-01 00:00:00

  • Biotransformation of sevoflurane in dogs and rats.

    abstract::Sevoflurane, 3% and 4% in oxygen was administered to four dogs for 3 hours. Sevoflurane was metabolized to inorganic fluoride and hexafluoroisopropanol. Serum fluoride concentrations reached peak values during 2 to 3 hours into anesthesia and averaged 18.5 micrometer/L (n = 2) and 20.0 +/- 4.8 (mean +/- SD) micrometer...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Martis L,Lynch S,Napoli MD,Woods EF

    更新日期:1981-04-01 00:00:00

  • Gamma-aminobutyric acid type A receptor β3 subunit forebrain-specific knockout mice are resistant to the amnestic effect of isoflurane.

    abstract:BACKGROUND:β3 containing γ-aminobutyric acid type A receptors (GABA(A)-Rs) mediate behavioral end points of IV anesthetics such as immobility and hypnosis. A knockout mouse with targeted forebrain deletion of the β3 subunit of the GABA(A)-R shows reduced sensitivity to the hypnotic effect of etomidate, as measured by t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Rau V,Oh I,Liao M,Bodarky C,Fanselow MS,Homanics GE,Sonner JM,Eger EI 2nd

    更新日期:2011-09-01 00:00:00

  • Thromboembolism after total hip replacement: role of epidural and general anesthesia.

    abstract::The effects of continuous epidural anesthesia and of general anesthesia on the incidence of thromboembolism following total hip replacement were studied. Sixty patients were randomly allotted to one of two groups receiving either epidural or general anesthesia. Epidural anesthesia (N = 30) consisted of 0.5% bupivacain...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Modig J,Borg T,Karlström G,Maripuu E,Sahlstedt B

    更新日期:1983-02-01 00:00:00