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Inflammatory changes after extradural anaesthesia may affect the spread of local anaesthetic within the extradural space

Igarashi, T ; Hirabayashi, Y ; Shimizu, R ; Mitsuhata, H ; Saitoh, K ; Fukuda, H ; Konishi, A ; Asahara, H

British journal of anaesthesia : BJA, 1996-09, Vol.77 (3), p.347-351 [Periódico revisado por pares]

Oxford: Elsevier Ltd

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Título:
Inflammatory changes after extradural anaesthesia may affect the spread of local anaesthetic within the extradural space
Autor: Igarashi, T ; Hirabayashi, Y ; Shimizu, R ; Mitsuhata, H ; Saitoh, K ; Fukuda, H ; Konishi, A ; Asahara, H
Assuntos: Adult ; Aged ; Aged, 80 and over ; Anesthesia ; Anesthesia, Epidural - adverse effects ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthetics, Local - pharmacokinetics ; Biological and medical sciences ; Endoscopy ; Epidural Space - metabolism ; Epidural Space - pathology ; Female ; Fiber Optic Technology ; Humans ; Local anesthesia. Pain (treatment) ; Male ; Medical sciences ; Mepivacaine - pharmacokinetics ; Middle Aged ; Spondylitis - etiology ; Spondylitis - pathology
É parte de: British journal of anaesthesia : BJA, 1996-09, Vol.77 (3), p.347-351
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Descrição: We have assessed cephalad spread of analgesia in 491 patients undergoing extradural anaesthesia at the L2-3 or L3-4 interspace. Patients were classified into one of three groups based on the number of previous lumbar extradural anaesthesia procedures: none (group I, n = 339), one (group II, n = 82), and two or more (group III, n = 70). Cephalad spread of analgesia was greater in group I than in groups II and III, regardless of the puncture site. In addition, we examined the extradural space using a flexible extraduroscope in 32 patients who were excluded from the analysis of spread. Extraduroscopy showed the extradural space to be patent in patients with no history of prior lumbar extradural anesthesia, but it was not clearly identified in patients who had received extradural anaesthesia one or more times because of aseptic inflammatory changes, including proliferation of connective tissue, adhesions between the dura mater and the ligamentum flavum, granulation and changes in the ligamentum flavum. Extradural anaesthesia may cause aseptic inflammatory changes in the extradural space which may reduce the spread of analgesia.
Editor: Oxford: Elsevier Ltd
Idioma: Inglês

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Inflammatory changes after extradural anaesthesia may affect the spread of local anaesthetic within the extradural space

Igarashi, T ; Hirabayashi, Y ; Shimizu, R ; Mitsuhata, H ; Saitoh, K ; Fukuda, H ; Konishi, A ; Asahara, H

Oxford: Elsevier Ltd

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