Digital pressure during interscalene block is clinically ineffective in preventing anesthetic spread to the cervical plexus.

Abstract:

:The application of digital pressure above the injection site during interscalene block has been advocated to prevent cephalad spread of local anesthetic. In prior studies, radiographs taken immediately after interscalene injection of radiographic contrast have supported this concept. However, the clinical efficacy of digital pressure has not been previously tested. If digital pressure were effective in inhibiting cephalad spread of local anesthetic, attenuation of both hemidiaphragmatic paresis and the resulting compromise in pulmonary function would be expected. Sensory, motor, and pulmonary effects were prospectively evaluated in 20 patients presenting for elective shoulder surgery. Patients were randomly assigned to receive interscalene block with or without digital pressure. No clinical differences were seen between groups. All 20 patients had ipsilateral hemidiaphragmatic paresis by ultrasonographic evaluation and large mean decreases in forced vital capacity, 31.2% +/- 7.8% (with digital pressure), 33.7% +/- 12.8% (without digital pressure), and forced expiratory volume at one second, 27.9% +/- 9.3% (with digital pressure), 33.7 +/- 12.8% (without digital pressure). Peak sensory level of anesthesia to pinprick was not significantly different between groups, each group having mean levels of C-2 to C-3. Digital pressure was ineffective in limiting the flow of local anesthetic into the cervical plexus. Digital pressure influenced neither the incidence of diaphragmatic paresis nor the resulting large decreases in pulmonary function that result from interscalene block.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Urmey WF,Grossi P,Sharrock NE,Stanton J,Gloeggler PJ

doi

10.1097/00000539-199608000-00028

subject

Has Abstract

pub_date

1996-08-01 00:00:00

pages

366-70

issue

2

eissn

0003-2999

issn

1526-7598

journal_volume

83

pub_type

临床试验,杂志文章,随机对照试验
  • Structure-affinity relationships and stereospecificity of several homologous series of local anesthetics for the beta2-adrenergic receptor.

    abstract:UNLABELLED:Local anesthetics inhibit binding of ligands to beta2-adrenergic receptors (beta2ARs), and, as a consequence, inhibit intracellular cAMP production. We hypothesized that among homologous local anesthetics, their avidity at inhibiting binding of tritiated dihydroalprenolol (3H-DHA) to beta2ARs would increase ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199708000-00017

    authors: Butterworth J,James RL,Grimes J

    更新日期:1997-08-01 00:00:00

  • Aggressive warming reduces blood loss during hip arthroplasty.

    abstract:UNLABELLED:We evaluated the effects of aggressive warming and maintenance of normothermia on surgical blood loss and allogeneic transfusion requirement. We randomly assigned 150 patients undergoing total hip arthroplasty with spinal anesthesia to aggressive warming (to maintain a tympanic membrane temperature of 36.5 d...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200010000-00039

    authors: Winkler M,Akça O,Birkenberg B,Hetz H,Scheck T,Arkiliç CF,Kabon B,Marker E,Grübl A,Czepan R,Greher M,Goll V,Gottsauner-Wolf F,Kurz A,Sessler DI

    更新日期:2000-10-01 00:00:00

  • The effects of femoral nerve blockade in conjunction with epidural analgesia after total knee arthroplasty.

    abstract::Either epidural analgesia or femoral nerve blockade improves analgesia and rehabilitation after total knee arthroplasty. No study has evaluated the combination of femoral nerve blockade and epidural analgesia. In this prospective, randomized, blinded study we investigated combining femoral nerve blockade with epidural...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000159150.79908.21

    authors: YaDeau JT,Cahill JB,Zawadsky MW,Sharrock NE,Bottner F,Morelli CM,Kahn RL,Sculco TP

    更新日期:2005-09-01 00:00:00

  • Hemodynamic effects of portal triad clamping with and without pneumoperitoneum: an echocardiographic study.

    abstract::The decrease of cardiac index observed during portal triad clamping (PTC) with and without pneumoperitoneum has been studied only with right heart catheterization. To better understand this decrease of cardiac index, we investigated the balance between the adequacy of preload and the ability of the heart to pump again...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000144592.20499.12

    authors: Decailliot F,Streich B,Heurtematte Y,Duvaldestin P,Cherqui D,Stéphan F

    更新日期:2005-03-01 00:00:00

  • Differences in pH management and pulsatile/nonpulsatile perfusion during cardiopulmonary bypass do not influence renal function.

    abstract::The renal effects of pulsatile (pulse pressure 18.0 +/- 1.5 mm Hg [mean +/- SEM]) or nonpulsatile perfusion (mean pulse pressure 1.9 +/- 0.4 mm Hg) during either alpha-stat (mean PaCO2 41.2 +/- 0.9 mm Hg measured at 37 degrees C) or pH-stat (mean PaCO2 60.6 +/- 1.7 mm Hg measured at 37 degrees C) pH management of hypo...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199211000-00007

    authors: Badner NH,Murkin JM,Lok P

    更新日期:1992-11-01 00:00:00

  • Intravenous lidocaine as a suppressant of coughing during tracheal intubation in elderly patients.

    abstract::The effects of intravenously administered lidocaine on cough suppression in elderly patients over the age of 60 yr during tracheal intubation under general anesthesia were evaluated in two studies. In the first study, 100 patients received a placebo of either 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min b...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199308000-00016

    authors: Yukioka H,Hayashi M,Terai T,Fujimori M

    更新日期:1993-08-01 00:00:00

  • Xenon Anesthesia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    abstract:BACKGROUND:Xenon anesthesia has been studied for decades. However, no meta-analysis of randomized controlled trials (RCTs) on xenon anesthesia has been conducted. The aim of this study was to systematically review all available evidence from RCTs comparing xenon and other inhaled and IV anesthetics on anesthetic outcom...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1213/ANE.0000000000000914

    authors: Law LS,Lo EA,Gan TJ

    更新日期:2016-03-01 00:00:00

  • The effectiveness of a simple novel approach on electroencephalograph instruction for anesthesiology residents.

    abstract:BACKGROUND:The electroencephalogram (EEG) measures cerebral activity and, because of its use as an intraoperative monitor, the Accreditation Council for Graduate Medical Education requires EEG monitoring experience during anesthesiology residency. To improve the anesthesiology residents' education at the University of ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000287666.72775.07

    authors: Fahy BG,Chau DF,Owen MB

    更新日期:2008-01-01 00:00:00

  • Quantification of Fibrinolysis Using Velocity Curves Measured with Thromboelastometry in Children with Congenital Heart Disease.

    abstract:BACKGROUND:In this pilot study, we hypothesized that velocity parameters obtained from changes in clot amplitude (A) and clot elasticity (E) measured with thromboelastometry (ROTEM, Tem International GmbH, Munich, Germany) could improve detection of fibrinolysis in whole blood obtained from children undergoing surgery ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000795

    authors: Faraoni D,Van der Linden P,Ducloy-Bouthors AS,Goobie SM,DiNardo JA,Nielsen VG

    更新日期:2015-08-01 00:00:00

  • Plasma concentrations of bupivacaine in neonates after continuous epidural infusion.

    abstract::This study reports plasma bupivacaine concentrations in 13 neonates who received lumbar epidural anesthesia during major abdominal surgery. A bolus of 1.8 mg/kg of bupivacaine (2.5 mg/mL) was administered after induction of anesthesia, followed by a continuous infusion of 0.2 mg.kg-1.h-1 (1.25 mg/mL). Plasma concentra...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-199703000-00006

    authors: Larsson BA,Lönnqvist PA,Olsson GL

    更新日期:1997-03-01 00:00:00

  • Risk Factors for Intraoperative Hypoglycemia in Children: A Multicenter Retrospective Cohort Study.

    abstract:BACKGROUND:Intraoperative hypoglycemia can result in devastating neurologic injury if not promptly diagnosed and treated. Few studies have defined risk factors for intraoperative hypoglycemia. The authors sought to characterize children with intraoperative hypoglycemia and determine independent risk factors in a multic...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004979

    authors: Riegger LQ,Leis AM,Golmirzaie KH,Malviya S

    更新日期:2020-06-25 00:00:00

  • Global end-diastolic volume during different loading conditions in a pediatric animal model.

    abstract:BACKGROUND:Estimating volume status in infants and neonates is challenging. Global end-diastolic volume (GEDV) and dynamic variables of preload, such as pulse pressure variation (PPV), may be alternative variables for estimating cardiac preload and fluid responsiveness. Therefore, we designed the present study to evalu...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000281152.72734.d0

    authors: Renner J,Meybohm P,Gruenewald M,Steinfath M,Scholz J,Boening A,Bein B

    更新日期:2007-11-01 00:00:00

  • Subcellular Energetics and Metabolism: Potential Therapeutic Applications.

    abstract::Part I of this review discussed the similarities between embryogenesis, mammalian adaptions to hypoxia (primarily driven by hypoxia-inducible factor-1 [HIF-1]), ischemia-reperfusion injury (and its relationship with reactive oxygen species), hibernation, diving animals, cancer, and sepsis, and it focused on the common...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000001865

    authors: Thiele RH

    更新日期:2017-06-01 00:00:00

  • Comparison of the Analgesic Duration of 0.5% Bupivacaine With 1:200,000 Epinephrine Versus 0.5% Ropivacaine Versus 1% Ropivacaine for Low-Volume Ultrasound-Guided Interscalene Brachial Plexus Block: A Randomized Controlled Trial.

    abstract:BACKGROUND:Bupivacaine and ropivacaine are the preferred long-acting local anesthetics for peripheral nerve blocks as they provide prolonged analgesia in the postoperative period. No studies have directly compared the analgesic duration of these commonly used local anesthetics in the setting of low-volume ultrasound-gu...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000005373

    authors: Safa B,Flynn B,McHardy PG,Kiss A,Haslam L,Henry PD,Kaustov L,Choi S

    更新日期:2021-01-15 00:00:00

  • Postoperative epidural analgesia and oral anticoagulant therapy.

    abstract::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 epidur...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199407000-00017

    authors: Horlocker TT,Wedel DJ,Schlichting JL

    更新日期:1994-07-01 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

    doi:10.1213/01.ane.0000237176.10774.17

    authors: Dexter F,Epstein RH

    更新日期:2006-12-01 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

  • Intrathecal midazolam II: combination with intrathecal fentanyl for labor pain.

    abstract:UNLABELLED:Recent investigations have sought to improve intrathecal analgesia by combining opioids with other classes of analgesics. In this study we assessed the ability of intrathecal midazolam to increase the potency and duration of the analgesic effects of intrathecal fentanyl without causing adverse effects. Thirt...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ane.0000112434.68702.e4

    authors: Tucker AP,Mezzatesta J,Nadeson R,Goodchild CS

    更新日期:2004-06-01 00:00:00

  • Optimization of Endotracheal Tube Cuff Pressure by Monitoring CO2 Levels in the Subglottic Space in Mechanically Ventilated Patients: A Randomized Controlled Trial.

    abstract:BACKGROUND:Many of the complications of mechanical ventilation are related to inappropriate endotracheal tube (ETT) cuff pressure. The aim of the current study was to evaluate the effectiveness of automatic cuff pressure closed-loop control in patients under prolonged intubation, where presence of carbon dioxide (CO2) ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1213/ANE.0000000000002358

    authors: Efrati S,Bolotin G,Levi L,Zaaroor M,Guralnik L,Weksler N,Levinger U,Soroksky A,Denman WT,Gurman GM

    更新日期:2017-10-01 00:00:00

  • Naloxone does not antagonize the analgesic effects of inhalation anesthetics.

    abstract::A previous demonstration that the ratio of analgesic to anesthetic endpoints is not constant across inhalation anesthetic agents implies that more than one mechanism of action may be operant in general anesthesia. We hypothesized that the endogenous opiate systems might account for this observed disparity in ratios. T...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Levine LL,Winter PM,Nemoto EM,Uram M,Lin MR

    更新日期:1986-04-01 00:00:00

  • Adverse cardiac outcomes after noncardiac surgery in patients with prior percutaneous transluminal coronary angioplasty.

    abstract:UNLABELLED:In this retrospective cohort study, we compared adverse cardiac outcomes after noncardiac surgery among patients with prior percutaneous transluminal coronary angioplasty (PTCA), patients with nonrevascularized coronary artery disease (CAD), and normal controls. Inpatient hospital discharge abstracts from al...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199909000-00003

    authors: Posner KL,Van Norman GA,Chan V

    更新日期:1999-09-01 00:00:00

  • Subblocking concentrations of local anesthetics: effects on impulse generation and conduction in single myelinated sciatic nerve axons in frog.

    abstract::Phenomena seen in axons exposed to subblocking doses serve as the basis for interpreting clinical and behavioral observations during onset and recovery of peripheral nerve block. To delineate the changes in excitability and in impulse conduction caused by subblocking concentrations of local anesthetics (LAs) in myelin...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199212000-00008

    authors: Raymond SA

    更新日期:1992-12-01 00:00:00

  • Comparison of the fascia iliaca compartment block with the 3-in-1 block in children.

    abstract::A new single injection procedure, the fascia iliaca compartment block, is described for blocking the femoral, lateral cutaneous, and obturator nerves. The technique consists of injecting a local anesthetic immediately behind the fascia iliaca at the union of the lateral with the two medial thirds of the inguinal ligam...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Dalens B,Vanneuville G,Tanguy A

    更新日期:1989-12-01 00:00:00

  • Influence of volume on the spread of local anesthetic-methylene blue solution after injection for intercostal block.

    abstract::The purpose of this study was to evaluate the influence of the volume of methylene blue-local anesthetic on the spread of the injectate along the costal pleura. Twenty patients undergoing elective thoracotomy were studied. Twelve patients received intercostal nerve injection with 10 mL of 0.5% bupivacaine with methyle...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199209000-00013

    authors: Moorthy SS,Dierdorf SF,Yaw PB

    更新日期:1992-09-01 00:00:00

  • Analgesic Effects of Oxycodone Relative to Those of Sufentanil, in the Presence of Midazolam, During Endoscopic Injection Sclerotherapy for Patients With Cirrhosis and Esophageal Varices.

    abstract:BACKGROUND:We evaluated the efficacy and gastroenterologist/patient satisfaction of midazolam combined with oxycodone, relative to that of midazolam combined with sufentanil, for anesthesia during endoscopic injection sclerotherapy (EIS) in patients with cirrhosis and esophageal varices. METHODS:Patients with cirrhosi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000003305

    authors: Quan Z,Luo C,Chi P,Wang L,He H

    更新日期:2018-08-01 00:00:00

  • The wolf is crying in the operating room: patient monitor and anesthesia workstation alarming patterns during cardiac surgery.

    abstract:BACKGROUND:Vital sign monitors and ventilator/anesthesia workstations are equipped with multiple alarms to improve patient safety. A high number of false alarms can lead to a "crying wolf" phenomenon with consecutively ignored critical situations. Systematic data on alarm patterns and density in the perioperative phase...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181fcc504

    authors: Schmid F,Goepfert MS,Kuhnt D,Eichhorn V,Diedrichs S,Reichenspurner H,Goetz AE,Reuter DA

    更新日期:2011-01-01 00:00:00

  • Onset, intensity of blockade and somatosensory evoked potential changes of the lumbosacral dermatomes after epidural anesthesia with alkalinized lidocaine.

    abstract::The onset and intensity of blockade of the lumbosacral dermatomes after epidural anesthesia with alkalinized lidocaine were investigated in a randomized, double-blind study in 26 patients. Control subjects (n = 13) received 20 mL of 1.37% lidocaine (1.5% lidocaine plus 1 mL saline per 10 mL lidocaine) with added 1:200...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Benzon HT,Toleikis JR,Dixit P,Goodman I,Hill JA

    更新日期:1993-02-01 00:00:00

  • A Forensic Disassembly of the BIS Monitor.

    abstract:BACKGROUND:The bispectral index (BIS) monitor has been available for clinical use for >20 years and has had an immense impact on academic activity in Anesthesiology, with >3000 articles referencing the bispectral index. Despite attempts to infer its algorithms by external observation, its operation has nevertheless rem...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000005220

    authors: Connor CW

    更新日期:2020-12-01 00:00:00

  • Routine cleaning and autoclaving does not remove protein deposits from reusable laryngeal mask devices.

    abstract:UNLABELLED:We tested the hypothesis that routine cleaning and autoclaving does not remove protein deposits from reusable laryngeal mask airways (LMAs). All previously used classic and flexible LMAs from a single hospital were tested. Each LMA was hand-washed in an enzymatic solution for 3 min, machine-washed with a dis...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000080154.76349.5b

    authors: Clery G,Brimacombe J,Stone T,Keller C,Curtis S

    更新日期:2003-10-01 00:00:00

  • Use of ProSeal laryngeal mask airway in 2114 adult patients: a prospective study.

    abstract:BACKGROUND:There have been numerous studies published on the ProSeal laryngeal mask airway (PLMA). However, few have investigated its utility in a large practice setting. We sought to gather comprehensive data about the characteristics, efficacy, and safety of its use by a representative group of anesthesiologists work...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e318189ac84

    authors: Goldmann K,Hechtfischer C,Malik A,Kussin A,Freisburger C

    更新日期:2008-12-01 00:00:00