Spinal Cord: A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.Anesthesia, Spinal: Procedure in which an anesthetic is injected directly into the spinal cord.Anesthesia, Local: A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.).Anesthesia, Epidural: Procedure in which an anesthetic is injected into the epidural space.Anesthesia, Inhalation: Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract.Anesthesia, Conduction: Injection of an anesthetic into the nerves to inhibit nerve transmission in a specific part of the body.Anesthesia, Intravenous: Process of administering an anesthetic through injection directly into the bloodstream.Anesthesia, Obstetrical: A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.Anesthesia Recovery Period: The period of emergence from general anesthesia, where different elements of consciousness return at different rates.Anesthesia, Dental: A range of methods used to reduce pain and anxiety during dental procedures.Injections, Spinal: Introduction of therapeutic agents into the spinal region using a needle and syringe.Anesthetics, Inhalation: Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173)Anesthetics, Intravenous: Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)Adjuvants, Anesthesia: Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.Propofol: An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.Anesthetics, Local: Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included.Spinal Cord Diseases: Pathologic conditions which feature SPINAL CORD damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord.Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.Methyl Ethers: A group of compounds that contain the general formula R-OCH3.Anesthesiology: A specialty concerned with the study of anesthetics and anesthesia.Anesthetics, Combined: The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.Spinal Nerve Roots: Paired bundles of NERVE FIBERS entering and leaving the SPINAL CORD at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots are efferent, comprising the axons of spinal motor and PREGANGLIONIC AUTONOMIC FIBERS.Monitoring, Intraoperative: The constant checking on the state or condition of a patient during the course of a surgical operation (e.g., checking of vital signs).Spinal Cord Neoplasms: Benign and malignant neoplasms which occur within the substance of the spinal cord (intramedullary neoplasms) or in the space between the dura and spinal cord (intradural extramedullary neoplasms). The majority of intramedullary spinal tumors are primary CNS neoplasms including ASTROCYTOMA; EPENDYMOMA; and LIPOMA. Intramedullary neoplasms are often associated with SYRINGOMYELIA. The most frequent histologic types of intradural-extramedullary tumors are MENINGIOMA and NEUROFIBROMA.Spinal Canal: The cavity within the SPINAL COLUMN through which the SPINAL CORD passes.Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.Spinal DiseasesSpinal Cord Compression: Acute and chronic conditions characterized by external mechanical compression of the SPINAL CORD due to extramedullary neoplasm; EPIDURAL ABSCESS; SPINAL FRACTURES; bony deformities of the vertebral bodies; and other conditions. Clinical manifestations vary with the anatomic site of the lesion and may include localized pain, weakness, sensory loss, incontinence, and impotence.Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general ANESTHESIA, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site.Spinal NeoplasmsLidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.Halothane: A nonflammable, halogenated, hydrocarbon anesthetic that provides relatively rapid induction with little or no excitement. Analgesia may not be adequate. NITROUS OXIDE is often given concomitantly. Because halothane may not produce sufficient muscle relaxation, supplemental neuromuscular blocking agents may be required. (From AMA Drug Evaluations Annual, 1994, p178)Spinal Stenosis: Narrowing of the spinal canal.Bupivacaine: A widely used local anesthetic agent.Spinal Fusion: Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed)Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)Anesthesia, Closed-Circuit: Inhalation anesthesia where the gases exhaled by the patient are rebreathed as some carbon dioxide is simultaneously removed and anesthetic gas and oxygen are added so that no anesthetic escapes into the room. Closed-circuit anesthesia is used especially with explosive anesthetics to prevent fires where electrical sparking from instruments is possible.Nerve Block: Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.Anesthetics, General: Agents that induce various degrees of analgesia; depression of consciousness, circulation, and respiration; relaxation of skeletal muscle; reduction of reflex activity; and amnesia. There are two types of general anesthetics, inhalation and intravenous. With either type, the arterial concentration of drug required to induce anesthesia varies with the condition of the patient, the desired depth of anesthesia, and the concomitant use of other drugs. (From AMA Drug Evaluations Annual, 1994, p.173)Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.Ambulatory Surgical Procedures: Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.Preanesthetic Medication: Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.Spinal Injuries: Injuries involving the vertebral column.Thiopental: A barbiturate that is administered intravenously for the induction of general anesthesia or for the production of complete anesthesia of short duration.Anesthesia, Caudal: Epidural anesthesia administered via the sacral canal.Muscular Atrophy, Spinal: A group of disorders marked by progressive degeneration of motor neurons in the spinal cord resulting in weakness and muscular atrophy, usually without evidence of injury to the corticospinal tracts. Diseases in this category include Werdnig-Hoffmann disease and later onset SPINAL MUSCULAR ATROPHIES OF CHILDHOOD, most of which are hereditary. (Adams et al., Principles of Neurology, 6th ed, p1089)Spinal Cord Ischemia: Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with ARTERIOSCLEROSIS, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to INFARCTION of spinal cord tissue.Pentobarbital: A short-acting barbiturate that is effective as a sedative and hypnotic (but not as an anti-anxiety) agent and is usually given orally. It is prescribed more frequently for sleep induction than for sedation but, like similar agents, may lose its effectiveness by the second week of continued administration. (From AMA Drug Evaluations Annual, 1994, p236)Anesthetics, Dissociative: Intravenous anesthetics that induce a state of sedation, immobility, amnesia, and marked analgesia. Subjects may experience a strong feeling of dissociation from the environment. The condition produced is similar to NEUROLEPTANALGESIA, but is brought about by the administration of a single drug. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed)Ganglia, Spinal: Sensory ganglia located on the dorsal spinal roots within the vertebral column. The spinal ganglion cells are pseudounipolar. The single primary branch bifurcates sending a peripheral process to carry sensory information from the periphery and a central branch which relays that information to the spinal cord or brain.Enflurane: An extremely stable inhalation anesthetic that allows rapid adjustments of anesthesia depth with little change in pulse or respiratory rate.Xylazine: An adrenergic alpha-2 agonist used as a sedative, analgesic and centrally acting muscle relaxant in VETERINARY MEDICINE.Intraoperative Complications: Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.Intubation, Intratracheal: A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.Pain, Postoperative: Pain during the period after surgery.Conscious Sedation: A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)Anesthesia Department, Hospital: Hospital department responsible for the administration of functions and activities pertaining to the delivery of anesthetics.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Thoracic Vertebrae: A group of twelve VERTEBRAE connected to the ribs that support the upper trunk region.Spine: The spinal or vertebral column.Motor Neurons: Neurons which activate MUSCLE CELLS.Cesarean Section: Extraction of the FETUS by means of abdominal HYSTEROTOMY.Anesthesia, IntratrachealParaplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness.Intraoperative Period: The period during a surgical operation.Laminectomy: A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Tuberculosis, Spinal: Osteitis or caries of the vertebrae, usually occurring as a complication of tuberculosis of the lungs.Lumbosacral Region: Region of the back including the LUMBAR VERTEBRAE, SACRUM, and nearby structures.Prilocaine: A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry.Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Anesthesia and Analgesia: Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure.Hematoma, Epidural, Spinal: A rare epidural hematoma in the spinal epidural space, usually due to a vascular malformation (CENTRAL NERVOUS SYSTEM VASCULAR MALFORMATIONS) or TRAUMA. Spontaneous spinal epidural hematoma is a neurologic emergency due to a rapidly evolving compressive MYELOPATHY.Methohexital: An intravenous anesthetic with a short duration of action that may be used for induction of anesthesia.Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Spinal Curvatures: Deformities of the SPINE characterized by abnormal bending or flexure in the vertebral column. They may be bending forward (KYPHOSIS), backward (LORDOSIS), or sideway (SCOLIOSIS).Lumbar Vertebrae: VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE.Posterior Horn Cells: Neurons in the SPINAL CORD DORSAL HORN whose cell bodies and processes are confined entirely to the CENTRAL NERVOUS SYSTEM. They receive collateral or direct terminations of dorsal root fibers. They send their axons either directly to ANTERIOR HORN CELLS or to the WHITE MATTER ascending and descending longitudinal fibers.Cervical Vertebrae: The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK.Electroencephalography: Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Mepivacaine: A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)Alfentanil: A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.Hypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.Consciousness: Sense of awareness of self and of the environment.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Surgical Procedures, Minor: Surgery restricted to the management of minor problems and injuries; surgical procedures of relatively slight extent and not in itself hazardous to life. (Dorland, 28th ed & Stedman, 25th ed)Spinal Muscular Atrophies of Childhood: A group of recessively inherited diseases that feature progressive muscular atrophy and hypotonia. They are classified as type I (Werdnig-Hoffman disease), type II (intermediate form), and type III (Kugelberg-Welander disease). Type I is fatal in infancy, type II has a late infantile onset and is associated with survival into the second or third decade. Type III has its onset in childhood, and is slowly progressive. (J Med Genet 1996 Apr:33(4):281-3)Midazolam: A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.Postoperative Nausea and Vomiting: Emesis and queasiness occurring after anesthesia.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Xenon: A noble gas with the atomic symbol Xe, atomic number 54, and atomic weight 131.30. It is found in the earth's atmosphere and has been used as an anesthetic.Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord.Spinal Fractures: Broken bones in the vertebral column.Analgesia: Methods of PAIN relief that may be used with or in place of ANALGESICS.Neuromuscular Nondepolarizing Agents: Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants.EthersSpinal Puncture: Tapping fluid from the subarachnoid space in the lumbar region, usually between the third and fourth lumbar vertebrae.Heart Rate: The number of times the HEART VENTRICLES contract per unit of time, usually per minute.Epidural Space: Space between the dura mater and the walls of the vertebral canal.Surgical Procedures, Operative: Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.)Chloralose: A derivative of CHLORAL HYDRATE that was used as a sedative but has been replaced by safer and more effective drugs. Its most common use is as a general anesthetic in animal experiments.Spinal Cord Regeneration: Repair of the damaged neuron function after SPINAL CORD INJURY or SPINAL CORD DISEASES.Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Ether: A mobile, very volatile, highly flammable liquid used as an inhalation anesthetic and as a solvent for waxes, fats, oils, perfumes, alkaloids, and gums. It is mildly irritating to skin and mucous membranes.Electric Stimulation: Use of electric potential or currents to elicit biological responses.Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Medetomidine: An agonist of RECEPTORS, ADRENERGIC ALPHA-2 that is used in veterinary medicine for its analgesic and sedative properties. It is the racemate of DEXMEDETOMIDINE.Hyperalgesia: An increased sensation of pain or discomfort produced by mimimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.Piperidines: A family of hexahydropyridines.Analgesics: Compounds capable of relieving pain without the loss of CONSCIOUSNESS.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Cats: The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801)Ephedrine: A phenethylamine found in EPHEDRA SINICA. PSEUDOEPHEDRINE is an isomer. It is an alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used for asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists.Quadriplegia: Severe or complete loss of motor function in all four limbs which may result from BRAIN DISEASES; SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; or rarely MUSCULAR DISEASES. The locked-in syndrome is characterized by quadriplegia in combination with cranial muscle paralysis. Consciousness is spared and the only retained voluntary motor activity may be limited eye movements. This condition is usually caused by a lesion in the upper BRAIN STEM which injures the descending cortico-spinal and cortico-bulbar tracts.Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes.Carticaine: A thiophene-containing local anesthetic pharmacologically similar to MEPIVACAINE.Consciousness Monitors: Devices used to assess the level of consciousness especially during anesthesia. They measure brain activity level based on the EEG.Hypotension: Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients.Laryngeal Masks: A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain patients. It is introduced into the hypopharynx to form a seal around the larynx thus permitting spontaneous or positive pressure ventilation without penetration of the larynx or esophagus. It is used in place of a facemask in routine anesthesia. The advantages over standard mask anesthesia are better airway control, minimal anesthetic gas leakage, a secure airway during patient transport to the recovery area, and minimal postoperative problems.Neuromuscular Blocking Agents: Drugs that interrupt transmission of nerve impulses at the skeletal neuromuscular junction. They can be of two types, competitive, stabilizing blockers (NEUROMUSCULAR NONDEPOLARIZING AGENTS) or noncompetitive, depolarizing agents (NEUROMUSCULAR DEPOLARIZING AGENTS). Both prevent acetylcholine from triggering the muscle contraction and they are used as anesthesia adjuvants, as relaxants during electroshock, in convulsive states, etc.Trigeminal Nucleus, Spinal: Nucleus of the spinal tract of the trigeminal nerve. It is divided cytoarchitectonically into three parts: oralis, caudalis (TRIGEMINAL CAUDAL NUCLEUS), and interpolaris.Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms.Manipulation, Spinal: Adjustment and manipulation of the vertebral column.Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma.Neuromuscular Blockade: The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.Intraoperative Awareness: Occurence of a patient becoming conscious during a procedure performed under GENERAL ANESTHESIA and subsequently having recall of these events. (From Anesthesiology 2006, 104(4): 847-64.)Disease Models, Animal: Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.Intraoperative Care: Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.Succinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.Laryngoscopy: Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope.Orthopedic Procedures: Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures.Paralysis: A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45)Manuals as Topic: Books designed to give factual information or instructions.Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the NERVOUS SYSTEM.Hypotension, Controlled: Procedure in which arterial blood pressure is intentionally reduced in order to control blood loss during surgery. This procedure is performed either pharmacologically or by pre-surgical removal of blood.Respiration: The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).Deep Sedation: Drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposely following repeated painful stimulation. The ability to independently maintain ventilatory function may be impaired. (From: American Society of Anesthesiologists Practice Guidelines)Anterior Horn Cells: MOTOR NEURONS in the anterior (ventral) horn of the SPINAL CORD which project to SKELETAL MUSCLES.Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body.Androstanols: Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.Shivering: Involuntary contraction or twitching of the muscles. It is a physiologic method of heat production in man and other mammals.Myelography: X-ray visualization of the spinal cord following injection of contrast medium into the spinal arachnoid space.Subarachnoid Space: The space between the arachnoid membrane and PIA MATER, filled with CEREBROSPINAL FLUID. It contains large blood vessels that supply the BRAIN and SPINAL CORD.Nociceptors: Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM.Physical Stimulation: Act of eliciting a response from a person or organism through physical contact.Etomidate: Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic.Afferent Pathways: Nerve structures through which impulses are conducted from a peripheral part toward a nerve center.Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.Sensation: The process in which specialized SENSORY RECEPTOR CELLS transduce peripheral stimuli (physical or chemical) into NERVE IMPULSES which are then transmitted to the various sensory centers in the CENTRAL NERVOUS SYSTEM.Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals.Postoperative Period: The period following a surgical operation.Evoked Potentials, Somatosensory: The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM.Urethane: Antineoplastic agent that is also used as a veterinary anesthetic. It has also been used as an intermediate in organic synthesis. Urethane is suspected to be a carcinogen.Operating Rooms: Facilities equipped for performing surgery.Scoliosis: An appreciable lateral deviation in the normally straight vertical line of the spine. (Dorland, 27th ed)Cordotomy: Any operation on the spinal cord. (Stedman, 26th ed)Dogs: The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)Ophthalmologic Surgical Procedures: Surgery performed on the eye or any of its parts.Hernia, Inguinal: An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.Droperidol: A butyrophenone with general properties similar to those of HALOPERIDOL. It is used in conjunction with an opioid analgesic such as FENTANYL to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon. It is also used as a premedicant, as an antiemetic, and for the control of agitation in acute psychoses. (From Martindale, The Extra Pharmacopoeia, 29th ed, p593)Blood Gas Analysis: Measurement of oxygen and carbon dioxide in the blood.Neurons, Afferent: Neurons which conduct NERVE IMPULSES to the CENTRAL NERVOUS SYSTEM.Decompression, Surgical: A surgical operation for the relief of pressure in a body compartment or on a body part. (From Dorland, 28th ed)Tetracaine: A potent local anesthetic of the ester type used for surface and spinal anesthesia.Needles: Sharp instruments used for puncturing or suturing.Hindlimb: Either of two extremities of four-footed non-primate land animals. It usually consists of a FEMUR; TIBIA; and FIBULA; tarsals; METATARSALS; and TOES. (From Storer et al., General Zoology, 6th ed, p73)Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Epinephrine: The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS.Nerve Regeneration: Renewal or physiological repair of damaged nerve tissue.Body Temperature: The measure of the level of heat of a human or animal.Amides: Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)Oxygen: An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration.Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the TIBIAL NERVE and the PERONEAL NERVE.Dexmedetomidine: A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.Cervical Plexus: A network of nerve fibers originating in the upper four CERVICAL SPINAL CORD segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head. It also distributes motor fibers to muscles of the cervical SPINAL COLUMN, infrahyoid muscles, and the DIAPHRAGM.Brain: The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM.Hypothermia: Lower than normal body temperature, especially in warm-blooded animals.Surgical Procedures, Elective: Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Analgesia, Epidural: The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.Myelitis: Inflammation of the spinal cord. Relatively common etiologies include infections; AUTOIMMUNE DISEASES; SPINAL CORD; and ischemia (see also SPINAL CORD VASCULAR DISEASES). Clinical features generally include weakness, sensory loss, localized pain, incontinence, and other signs of autonomic dysfunction.Spinal Cord Stimulation: Application of electric current to the spine for treatment of a variety of conditions involving innervation from the spinal cord.Laryngismus: A disorder in which the adductor muscles of the VOCAL CORDS exhibit increased activity leading to laryngeal spasm. Laryngismus causes closure of the VOCAL FOLDS and airflow obstruction during inspiration.Acepromazine: A phenothiazine that is used in the treatment of PSYCHOSES.Mandibular Nerve: A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura.Clonidine: An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.Muscle Relaxants, Central: A heterogeneous group of drugs used to produce muscle relaxation, excepting the neuromuscular blocking agents. They have their primary clinical and therapeutic uses in the treatment of muscle spasm and immobility associated with strains, sprains, and injuries of the back and, to a lesser degree, injuries to the neck. They have been used also for the treatment of a variety of clinical conditions that have in common only the presence of skeletal muscle hyperactivity, for example, the muscle spasms that can occur in MULTIPLE SCLEROSIS. (From Smith and Reynard, Textbook of Pharmacology, 1991, p358)Dura Mater: The outermost of the three MENINGES, a fibrous membrane of connective tissue that covers the brain and the spinal cord.Nurse Anesthetists: Professional nurses who have completed postgraduate training in the administration of anesthetics and who function under the responsibility of the operating surgeon.Injections: Introduction of substances into the body using a needle and syringe.

Dose-response effects of spinal neostigmine added to bupivacaine spinal anesthesia in volunteers. (1/609)

BACKGROUND: Intrathecal adjuncts often are used to enhance small-dose spinal bupivacaine for ambulatory anesthesia. Neostigmine is a novel spinal analgesic that could be a useful adjunct, but no data exist to assess the effects of neostigmine on small-dose bupivacaine spinal anesthesia. METHODS: Eighteen volunteers received two bupivacaine spinal anesthetics (7.5 mg) in a randomized, double-blinded, crossover design. Dextrose, 5% (1 ml), was added to one spinal infusion and 6.25, 12.5, or 50 microg neostigmine in dextrose, 5%, was added to the other spinal. Sensory block was assessed with pinprick; by the duration of tolerance to electric stimulation equivalent to surgical incision at the pubis, knee, and ankle; and by the duration of tolerance to thigh tourniquet. Motor block at the quadriceps was assessed with surface electromyography. Side effects (nausea, vomiting, pruritus, and sedation) were noted. Hemodynamic and respiratory parameters were recorded every 5 min. Dose-response relations were assessed with analysis of variance, paired t tests, or Spearman rank correlation. RESULTS: The addition of 50 microg neostigmine significantly increased the duration of sensory and motor block and the time until discharge criteria were achieved. The addition of neostigmine produced dose-dependent nausea (33-67%) and vomiting (17-50%). Neostigmine at these doses had no effect on hemodynamic or respiratory parameters. CONCLUSIONS: The addition of 50 microg neostigmine prolonged the duration of sensory and motor block. However, high incidences of side effects and delayed recovery from anesthesia with the addition of 6.25 to 50 microg neostigmine may limit the clinical use of these doses for outpatient spinal anesthesia.  (+info)

Transdermal nitroglycerine enhances spinal sufentanil postoperative analgesia following orthopedic surgery. (2/609)

BACKGROUND: Sufentanil is a potent but short-acting spinal analgesic used to manage perioperative pain. This study evaluated the influence of transdermal nitroglycerine on the analgesic action of spinal sufentanil in patients undergoing orthopedic surgery. METHODS: Fifty-six patients were randomized to one of four groups. Patients were premedicated with 0.05-0.1 mg/kg intravenous midazolam and received 15 mg bupivacaine plus 2 ml of the test drug intrathecally (saline or 10 microg sufentanil). Twenty to 30 min after the spinal puncture, a transdermal patch of either 5 mg nitroglycerin or placebo was applied. The control group received spinal saline and transdermal placebo. The sufentanil group received spinal sufentanil and transdermal placebo. The nitroglycerin group received spinal saline and transdermal nitroglycerine patch. Finally, the sufentanil-nitroglycerin group received spinal sufentanil and transdermal nitroglycerine. Pain and adverse effects were evaluated using a 10-cm visual analog scale. RESULTS: The time to first rescue analgesic medication was longer for the sufentanil-nitroglycerin group (785+/-483 min) compared with the other groups (P<0.005). The time to first rescue analgesics was also longer for the sufentanil group compared with the control group (P<0.05). The sufentanil-nitroglycerin group group required less rescue analgesics in 24 h compared with the other groups (P<0.02) and had lesser 24-h pain visual analog scale scores compared with the control group (P<0.005), although these scores were similar to the sufentanil and nitroglycerin groups (P>0.05). The incidence of perioperative adverse effects was similar among groups (P>0.05). CONCLUSIONS: Transdermal nitroglycerine alone (5 mg/day), a nitric oxide generator, did not result in postoperative analgesia itself, but it prolonged the analgesic effect of spinal sufentanil (10 microg) and provided 13 h of effective postoperative analgesia after knee surgery.  (+info)

Assessing introduction of spinal anaesthesia for obstetric procedures. (3/609)

To assess the impact of introducing spinal anaesthesia for obstetric operative procedures on use of general anaesthesia and quality of regional anaesthesia in a unit with an established epidural service a retrospective analysis of routinely collected data on method of anaesthesia, efficacy, and complications was carried out. Data were collected from 1988 to 1991 on 1670 obstetric patients requiring an operative procedure. The introduction of spinal anaesthesia in 1989 significantly reduced the proportion of operative procedures performed under general anaesthesia, from 60% (234/390) in 1988 to 30% (124/414) in 1991. The decrease was most pronounced for manual removal of the placenta (88%, 48/55 v 9%, 3/34) and emergency caesarean section (67%, 129/193) v 38%, 87/229). Epidural anaesthesia decreased in use most significantly for elective caesarean section (65%, 77/118 v 3% 3/113; x2=139, p<0.0001). The incidence of severe pain and need for conversion to general anaesthesia was significantly less with spinal anaesthesia (0%, 0/207 v 3%, 5/156; p<0.05). Hypotension was not a problem, and the incidence of headache after spinal anaesthetic decreased over the period studied. Introducing spinal anaesthesia therefore reduced the need for general anaesthesia and improved the quality of regional anaesthesia.  (+info)

Incidence of bradycardia during recovery from spinal anaesthesia: influence of patient position. (4/609)

We administered 0.5% plain bupivacaine 4 ml intrathecally (L2-3 or L3-4) in three groups of 20 patients, according to the position in which they were nursed in the post-anaesthesia care unit (PACU): supine horizontal, 30 degrees Trendelenburg or hammock position (trunk and legs 30 degrees elevated). Patients were observed until anaesthesia descended to less than S1. The incidence of severe bradycardia (heart rate < 50 beat min-1) in the PACU was significantly higher in patients in the Trendelenburg position (60%) than in the horizontal (20%, P < 0.01) or hammock (10%, P < 0.005) position. After 90 min, following admission to the PACU, only patients in the hammock position did not have severe bradycardia. In this late phase, the incidence of severe bradycardia in the Trendelenburg group was 35% (P < 0.005) and 10% in patients in the supine horizontal position. In four patients, severe bradycardia first occurred later than 90 min after admission to the PACU. The latest occurrence of severe bradycardia was recorded 320 min after admission to the PACU. We conclude that for recovery from spinal anaesthesia, the Trendelenburg position should not be used and the hammock position is preferred.  (+info)

Hyperbaric spinal ropivacaine: a comparison to bupivacaine in volunteers. (5/609)

BACKGROUND: Ropivacaine is a newly introduced local anesthetic that may be a useful alternative to low-dose bupivacaine for outpatient spinal anesthesia. However, its relative potency to bupivacaine and its dose-response characteristics are unknown. This double-blind, randomized, crossover study was designed to determine relative potencies of low-dose hyperbaric spinal ropivacaine and bupivacaine and to assess the suitability of spinal ropivacaine for outpatient anesthesia. METHODS: Eighteen healthy volunteers were randomized into three equal groups to receive one spinal administration with bupivacaine and a second with ropivacaine, of equal-milligram doses (4, 8, or 12 mg) of 0.25% drug with 5% dextrose. The duration of blockade was assessed with (1) pinprick, (2) transcutaneous electrical stimulation, (3) tolerance to high tourniquet, (4) electromyography and isometric force dynamometry, and (5) achievement of discharge criteria. Differences between ropivacaine and bupivacaine were assessed with linear and multiple regression. P < 0.05 was considered significant. RESULTS: Ropivacaine and bupivacaine provided dose-dependent prolongation of sensory and motor block and time until achievement of discharge criteria (R2 ranges from 0.33-0.99; P values from < 0.001 through 0.01). Spinal anesthesia with ropivacaine was significantly different from bupivacaine and was approximately half as potent for all criteria studied. A high incidence of back pain (28%; P = 0.098) was noted after intrathecal ropivacaine was given. CONCLUSION: Ropivacaine is half as potent and in equipotent doses has a similar profile to bupivacaine with a higher incidence of side effects. Low-dose hyperbaric spinal ropivacaine does not appear to offer an advantage over bupivacaine for use in outpatient anesthesia.  (+info)

Sedation depends on the level of sensory block induced by spinal anaesthesia. (6/609)

We have investigated the relationship between the extent of spinal block and occurrence of sedation. In a first series of 43 patients, the distribution of sedation score (measured on the Ramsey scale) was related to the extent of spinal block (pinprick). In a second series of 33 patients, the relationship between sedation score and spinal block persisted after injection of midazolam 1 mg. This study confirmed that high spinal block was associated with increased sedation.  (+info)

Anaesthetic management of a woman who became paraplegic at 22 weeks' gestation after a spontaneous spinal cord haemorrhage secondary to a presumed arteriovenous malformation. (7/609)

A 19-yr-old woman developed a paraplegia with a T10 sensory level at 22 weeks' gestation. The spinal injury was caused by spontaneous bleed of a presumed arteriovenous malformation in the spinal cord. She presented for Caesarean section at term because of the breech position of her fetus. The successful use of a combined spinal epidural-regional anaesthetic is described and the risks of general and regional anaesthesia are discussed.  (+info)

Spinal versus epidural anesthesia for cesarean section in severely preeclamptic patients: a retrospective survey. (8/609)

BACKGROUND: Selection of spinal anesthesia for severely preeclamptic patients requiring cesarean section is controversial. Significant maternal hypotension is believed to be more likely with spinal compared with epidural anesthesia. The purpose of this study was to assess, in a large retrospective clinical series, the blood pressure effects of spinal and epidural anesthesia in severely preeclamptic patients requiring cesarean section. METHODS: The computerized medical records database was reviewed for all preeclamptic patients having cesarean section between January 1, 1989 and December 31, 1996. All nonlaboring severely preeclamptic patients receiving either spinal or epidural anesthesia for cesarean section were included for analysis. The lowest recorded blood pressures were compared for the 20-min period before induction of regional anesthesia, the period from induction of regional anesthesia to delivery, and the period from delivery to the end of operation. RESULTS: Study groups included 103 women receiving spinal anesthesia and 35 receiving epidural anesthesia. Changes in the lowest mean blood pressure were similar after epidural or spinal anesthesia. Intraoperative ephedrine use was similar for both groups. Intraoperative crystalloid administration was statistically greater for patients receiving spinal versus epidural anesthesia (1780 +/- 838 vs. 1359 +/- 674 ml, respectively). Neonatal Apgar scores and incidence of maternal intensive care unit admission or postoperative pulmonary edema were also similar. CONCLUSION: Although we cannot exclude the possibility that the spinal and epidural anesthesia groups were dissimilar, the magnitudes of maternal blood pressure declines were similar after spinal or epidural anesthesia in this series of severely preeclamptic patients receiving cesarean section. Maternal and fetal outcomes also were similar.  (+info)

Continuous Spinal Anaesthesia is a recognized technique for providing anaesthesia for various surgical procedures. It may be an alternative to general anaesthesia in high-risk elderly patients requiring emergency laparotomy. The objective was to evaluate the benefits of continuous spinal anaesthesia in providing effective anaesthesia for emergency laparotomy, in enhancing recovery after major abdominal surgery and in reducing length of stay in the intensive care unit in high-risk elderly patients. Prospective service evaluation was performed at a tertiary care university hospital. High-risk elderly patients were offered both general anaesthesia and continuous spinal anaesthesia. An 18-gauge macro catheter was inserted into the intrathecal space through a 16-gauge Tuohy needle. Sedation was maintained with remifentanil. Prophylactic anti-emetics were administered. Blood pressure was maintained with an infusion of metaraminol. Over a 27-month period, 25 high risk elderly patients were offered continuous
BACKGROUND: Pre-loading with hetastarch decreases the incidence and severity of hypotension after spinal anesthesia for cesarean delivery. However, pharmacokinetic studies with crystalloid predict that fluid loading should be more efficacious if rapidly administered immediately after induction of spinal anesthesia. The aim of this study was to compare pre- and co-loading of hetastarch for the prevention of hypotension following spinal anesthesia for cesarean delivery.. METHODS: Forty-six healthy term parturients scheduled for cesarean delivery were randomized to receive 500 mL of 6% hetastarch intravenously, either slowly before spinal anesthesia (pre-loading) or as quickly as possible immediately after spinal anesthesia (co-loading). Systolic blood pressure was maintained at or above 90% of baseline with intravenous vasopressor boluses (ephedrine 5mg/mL+phenylephrine 25 microg/mL). The primary outcome was the volume of vasopressor mix required. Secondary outcomes included blood pressure and ...
It is a common observation that following spinal anaesthesia, the penis usually elongates. The aim of this study was to determine the degree of change in penile length following spinal anaesthesia. Consecutive urosurgical patients undergoing spinal anaesthesia were recruited for this study. Those who received general anaesthesia or incomplete spinal blocked were also excluded. The flaccid length of the penis was measured before and after the administration of spinal anaesthesia. Penile length 15 minutes post-spinal anaesthesia was measured and recorded. The change in length was tested for statistical significant difference, the age of patient; diagnosis and type of surgery were also recorded. Forty three patients completed the study. Benign prostatic hypertrophy constituted 41.9% of the surgical indications. While 53.5% of the patients were ASA I, 39.5% and 7.0% of them were ASA II and III respectively. While the mean initial penile length was 12.1 ± 0.53 cm and the mean final length was 15.7 ± 0.53
Define spinal anesthetic. spinal anesthetic synonyms, spinal anesthetic pronunciation, spinal anesthetic translation, English dictionary definition of spinal anesthetic. Noun 1. spinal anesthetic - an anesthetic that is injected into the spine spinal anaesthetic anaesthetic, anaesthetic agent, anesthetic, anesthetic agent -...
Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block, is a form of regional anaesthesia involving the injection of a local anaesthetic into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long. For obese patients longer needles are available (12.7 cm / 5 inches). The tip of the spinal needle has a point or small bevel. Recently, pencil point needles have been made available (Whitacre, Sprotte, Gertie Marx and others). Spinal anaesthesia is a commonly used technique, either on its own or in combination with sedation or general anaesthesia. Examples of uses include: Orthopaedic surgery on the pelvis, hip, femur, knee, tibia, and ankle, including arthroplasty and joint replacement Vascular surgery on the legs Endovascular aortic aneurysm repair Hernia (inguinal or epigastric) Haemorrhoidectomy Nephrectomy and cystectomy in combination with general anaesthesia Transurethral resection of the ...
Health,...Study also finds spinal anesthesia doesnt worsen pre-existing RLS ...WEDNESDAY Nov. 19 (HealthDay News) -- Spinal anesthesia wont cause o...Thats the conclusion of a new study published as a letter to the edit... Our study was designed to test the hypothesis that spinal anesthesia ...,Spinal,Anesthesia,Doesnt,Cause,Restless,Leg,Syndrome,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Accepted: 12 March 2018 Abstract. Introduction: The purpose of the present study was to compare the effect of ENTONOX inhalation and spinal injection on the reduction of labor pain, the Apgar score of the neonates, and their side effects on new-born children and pregnant women.. Material and Methods: The present clinical trial study is conducted among the pregnant women in the maternity ward of a child delivery hospital in Iran. All Participants were divided in two groups ENTONOX Inhalation and Spinal Anesthesia. Visual Analogue Scale (VAS) was implemented to measure the pain level experienced by the participants during the procedure. Moreover, the Apgar scale was used to measure the general physical health of the neonates in both groups. In addition, the participants receiving ENTONOX were asked to report the side effects they underwent during gas inhalation. However, the participants in the spinal anesthesia were checked three times. Statistical analysis was performed using SPSS version ...
It is hypothesized that high spinal anesthesia combined with general anesthesia decreases the intraoperative stress and inflammatory response and improve post-operative pain control and respiratory function in this patient population. It is also hypothesized that the technique will provide stable intraoperative hemodynamics during aortic valve replacement surgery.. Stress response: Levels of hormones such as epinephrine, norepinephrine and cortisol are elevated during cardiac surgery and on the initiation of cardiopulmonary bypass. This stress response has previously been shown to be blunted with the use of high spinal anesthesia when combined with general anesthesia in coronary artery bypass surgery patients (Lee, Grocott, et al).. Inflammatory response: In addition to the stress response there is also an accentuated inflammatory response. With contact of the patients blood to the artificial bypass circuit, there is activation of various plasma protease pathways that generate multiple ...
The addition of vasoconstrictors for spinal anesthesia is controversial, since an increase in the incidence of transient neurologic symptoms (TNS) has been reported. A multicenter, randomized, double-blind study was conducted to assess the effectiveness of spinal anesthesia with phenylephrine in addition to tetracaine as well as the incidence of neurological complications. We studied 64 patients with comparable demographic characteristics who were scheduled for elective surgery for a lower limb, or a gynecological or urological procedure. The patients were allocated randomly into 2 groups. Group P (n = 34) received 0.5% tetracaine in 10% glucose with 0.025% phenylephrine, while group C (n = 30) received 0.5% tetracaine in 10% glucose ...
The advantages of spinal anesthesia under certain restrictions are so obvious and the results obtained from its use so excellent that one can appreciate the popularity of this valuable anesthetic measure. However, from time to time, there have appeared in the literature reports of patients who have developed neurological complications occurring immediately after or remotely following the administration of a spinal anesthetic. The statements in the literature are extremely contradictory as to the frequency with which such nervous sequelae occur. Emmett1 reports he had no neurological sequelae in 1415 cases, and Foss and Schwalm2 state that in 3,000 cases they ...
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The incidence of spinal anesthesia-induced hypotension in pregnant women undergoing a cesarean section is high. A preoperative fluid bolus of undetermined volume is frequently administered to lower the incidence of maternal hypotension, with a somewhat poor efficacy. Recently, several investigations have shown that the use of a phenylephrine infusion after the induction of spinal anesthesia results in a significant reduction in hypotensive episodes. Given the high efficacy of this therapy (incidence of hypotension around 20%), it is possible to determine the effective volume of fluid which would prevent hypotension in 50% of the patients studied (ED50).. Healthy term pregnant women undergoing elective cesarean section under spinal anesthesia will be recruited in this trial. The spinal anesthesia regimen will be standardized and all subjects will receive a phenylephrine infusion. The fluid investigated is hydroxyethylstarch (HES) 130/0.4 (Volulyte(R)). The ED50 will be determined using an up-down ...
The aim of the study was to review maternal hypotension during caesarean delivery with spinal anesthesia. Obstetric complications, such as obstetric hemorrhage and problems related to concomitant maternal diseases are not considered. Reports of hypotension during spinal anesthesia for elective caesarean delivery are frequent (70-80%) when pharmacological prophylaxis is not used. Although some physical methods (leg wrapping, thromboembolic stockings) and the prevention of aorto-caval compression (left lateral tilt of the uterus) are useful, main prevention relies on two pharmacological methods, vasopressor therapy and intravascular fluid loading generally in combination. Ephedrine has been the vasopressor of choice in obstetrics for decades but phenylephrine is now the preferred first line approach during elective procedures at least. Crystalloid preloading is clinically ineffective and should be abandoned. Crystalloid coloading at the onset of sympathetic blockade is better but its efficacy may ...
Abstract:. Aims: The study was undertaken to search for an alternative technique to preloading with less or no side effects. Settings and Design: A total of 100 female patients of ASA class I and II undergoing abdominal hysterectomy were enrolled in the study. Two groups namely Group A and Group B were made. All the patients received 2.6ml of 0.5% Bupivacaine heavy intrathecally at L3-L4 level in lateral decubitus using 25 gauge Quinckes spinal needle. Patients of Group A were placed in Trendelenberg position after spinal anesthesia and patients of Group B received preloading with Lactated Ringers solution before spinal anaesthesia. Assessment of hemodynamics (intraoperative and post operative) and side effects was done. Statistics: Data are expressed as mean + SD. Group comparisons were made using unpaired t-test. Results: Intraoperative blood loss and intraoperative requirement of Inj. Mephentermine was significantly less in Group A in comparison to Group B. Conclusion: Trendelenberg ...
Spinal anesthesia is a type of neuraxial anesthesia; local anesthetic (LA) is injected into cerebrospinal fluid (CSF) in the lumbar spine to anesthetize nerves that exit the spinal cord. Spinal anesthesia is most commonly used for anesthesia and/or a
In their study, Williams et al. sought to isolate the effect of surgery from that of general anesthesia by retrospectively comparing the cognitive outcomes of a cohort of infants who had undergone a brief surgical procedure under spinal anesthesia to normative data for the population of Vermont. The authors are to be commended for their contribution in assessing whether a surgical procedure may contribute to adverse cognitive outcome later in childhood. The Pediatric Anesthesia & Neurodevelopment Assessment (Columbia) and Mayo Anesthesia Safety in Kids (Mayo) studies, although not randomized controlled trials, will augment the insights gained from the General Anesthesia Spinal Anesthesia (GAS) study now underway at several U.S. and international sites. None, however, will report definitive outcomes for at least two or three years. In the meantime, we must content ourselves with very important but severely limited studies such as that published by Williams et al. in this issue of Anesthesia & ...
Background: To evaluate general anesthesia with sevoflurane vs spinal anesthesia with low dose lidocaine 5% onhemodynamics changes in patients undergoing hip fracture surgery.Methods: In this randomized double blind trial 100 patients (50 patients in each group) older than 60 years underhip surgery were randomized in general anesthesia with sevoflurane and spinal anesthesia with lidocaine 5%.Hemodynamic changes including mean arterial pressure (MAP) and heart rate, blood loss, pain severity, nausea andvomiting and opioids consumption were compared in two groups.Results: During surgery, difference between two groups regarding changes in mean arterial pressure was notsignificant, but the changes in heart rate were significantly different. Mean arterial pressure changes during recoverybetween two groups were significantly different. But there was no significant difference in heart rate changes. Bleedingin the sevoflurane group was significantly more than spinal group (513.ml vs. 365 ml). Moreover, AS Score
https://doi.org/10.31386/dmj.2019.13.1.2. Background:There are several theories to explain the action of local anesthetic in combined spinal-epidural anesthesia (CSE), this study is to examine a technique of (CSE) that depends on the theory of leakage of epidural drugs to the subarachnoid cerebrospinal fluid (CSF).. Patients and Methods:After approval of local medical ethics committee and obtaining informed consent, 60 patients (18-80 years, ASA physical status I to IV) who listed for orthopedic lower limb surgery under CSE were included in this study. The study design was prospective Cross-Section comparative one. It was done in Gulan General Hospital and Gian Private Hospital in Duhok Governorate in Kurdistan Region of Iraq in the period from 01/01/2017 to 28/2/2018.. Results:the volume needed to get maximum sensory block (MSB) and the frequency of top-up doses are greater in group A than B.The onset time of group A is longer than group B. The mean arterial pressure was much stable in group A ...
Background: Headache is the most common complication caused by spinal anesthesia. Systematic educational programs about conservative treatments could be effective in the reduction of headache after spinal anesthesiz. Aim: This study aimed to evaluate the effects of training programs on the headache of patients after spinal anesthesia. Method: This empirical study was conducted on 120 patients within the age range of 16-40 years who were candidates for general, orthopedic and urology surgeries in Dr. Shahidzadeh Hospital of Behbahan, Iran in 2015. Patients were randomly divided into two groups of intervention and control. Scheduled training was provided for the intervention group, and the control group received routine training. Intensity of headache was recorded using the visual analogue scale (VAS). Data analysis was performed in SPSS V.14 using Chi-square and independent T-test. Results: In this study, Chi-square test showed a statistically significant difference between the groups in terms of
Among the complications of spinal anaesthesia, 6th cranial nerve palsy occurs rarely. There is a possibility of encountering nerve injury during subarachnoid injections due to a long extracranial course. The symptoms appear as a result of ocular muscle paralysis. These symptoms often begin after the 4th day and spontaneous recovery lasts for weeks to months. We present a case in which Nervous Abducens palsy occurred following spinal anaesthesia for double j ureteral catheter placement surgery.. Keywords: Abducens nerve, spinal anaesthesia, diplopia, double j stent, ...
One of the potential risks of spinal anesthesia is that it fails to achieve adequate surgical anesthesia.(7) More importantly, planning for the management of patients with a failed spinal is arguably one of the most important considerations for the pre-operative discussion and intra-operative management. At Vermont, patients are counseled that in the event that the spinal is not successful, the procedure will be canceled and re-scheduled for a later date. This decision has been reached unanimously between surgeons, anesthesiologists, perioperative nurses, pediatricians and neonatologists. Pediatric anesthesiologists must always be prepared to provide respiratory support to infants following spinal anesthesia. Dr. Williams commented that an important finding of the GAS trial is infant spinal anesthesia can be achieved effectively throughout the world. Regarding the practical aspects, Dr. Williams described experience with tetracaine, ropivacaine, hyperbaric and isobaric bupivacaine. He did not ...
Dilation of lymphatic vessels may contribute to iatrogenic dissemination of cancer cells during surgery. We sought to determine whether neuraxial anesthesia reduces regional lymphatic flow. Using nuclear lymphoscintigraphy, 5 participants receiving spinal anesthesia for brachytherapy had lower extremity lymph flow at rest compared with flow under conditions of spinal anesthesia. Six limbs were analyzed. Four limbs were excluded because of failure to demonstrate lymph flow (1 patient, 2 limbs), colloid injection error (1 limb), and undiagnosed deep vein thrombosis (1 limb). All analyzed limbs showed reduced lymph flow washout from the pedal injection site (range 62%-100%) due to neuraxial anesthesia. Lymph flow was abolished in 3 limbs. We report proof-of-concept that neuraxial anesthesia reduces lymphatic flow through a likely mechanism of sympathectomy ...
Baricity refers to the density of a substance compared to the density of human cerebrospinal fluid. Baricity is used in anesthesia to determine the manner in which a particular drug will spread in the intrathecal space. Solutions that have a baricity approaching 1.000 are referred to as isobaric, as the density of the cerebrospinal fluid is approximately 1.0003+/- 0.0003. Solutions with a baricity less than 0.999 are termed hypobaric, and are usually created by mixing the local anesthetic with distilled water. Hyperbaric solutions are created by mixing dextrose 5-8% with the desired local anesthetic. Hyperbaric solutions will flow in the direction of gravity and settle in the most dependent areas of the intrathecal space. Conversely, hypobaric mixtures will rise in relation to gravitational pull. These properties allow the anesthesia provider to preferentially control the spread of the block by choice of mixture and patient positioning. Barash, Paul G.; Cullen, Bruce F.; Stoelting, Robert K. F ...
Epidural and spinal blocks are types of anesthesia in which a local anesthetic is injected near the spinal cord and nerve roots. It blocks pain from an entire region of the body, such as the belly, the hips, the legs, or the pelvis. Epidural and spinal anesthesia are used mainly for surgery of the lower belly and the legs. Epidural anesthesia is often used in childbirth. But it can also be used to help control pain after major surgery to the belly or chest.. Epidural anesthesia involves the insertion of a hollow needle and a small, flexible catheter into the space between the spinal column and outer membrane of the spinal cord (epidural space) in the middle or lower back. The area where the needle will be inserted is numbed with a local anesthetic. Then the needle is inserted and removed after the catheter has passed through it. The catheter remains in place. The anesthetic medicine is injected into the catheter to numb the body above and below the point of injection as needed. The catheter is ...
Background and Aims: Many unilateral lower limb orthopedic surgeries are conducted under unilateral spinal anesthesia with full flexion of spine and immediate extension after local anesthetic administration into the subarachnoid space. Studies have shown that extension of the spine in lateral decubitous position makes cauda equina to sink to the dependent side due to gravity. Continuous flexion of the spine causes sunken cauda equina to be suspended in the middle of the subarachnoid space increasing the possibility of unilateralization of the block. Hence, this study was carried out to assess the effect of flexion and extension in lateral decubitus position in unilateral spinal anesthesia. Material and Methods: Sixty patients posted for elective unilateral lower limb below knee orthopedic surgeries were randomly allocated into two groups-group F (flexion of spine) and group E (extension of spine). Using a 25-gauge Quincke spinal needle, 8 mg of 0.5% hyperbaric bupivacaine was injected over a ...
S. Datta, J. L. Kitzmiller, M. H. Alper, M. Galins; MATERNAL AND FETAL ACID-BASE STATUS FOLLOWING ELECTIVE CESAREAN SECTION UNDER SPINAL ANESTHESIA: INFUSION OF DEXTROSE VS NON-DEXTROSE SOLUTIONS. Anesthesiology 1980;53(3 Suppl):S305. Download citation file:. ...
Background: Observational studies on pediatric anesthesia neurotoxicity have been unable to distinguish long-term effects of general anesthesia (GA) from factors associated with the need for surgery. A recent study on elementary school children who had received a single GA during the first year of life demonstrated an association in otherwise healthy children between the duration of anesthesia and diminished test scores and also revealed a subgroup of children with "very poor academic achievement" (VPAA), scoring below the fifth percentile on standardized testing. Analysis of postoperative cognitive function in a similar cohort of children anesthetized with an alternative to GA may help to begin to separate the effects of anesthesia from other confounders.. Methods: We used a novel methodology to construct a combined medical and educational database to search for these effects in a similar cohort of children receiving spinal anesthesia (SA) for the same procedures. We compared former patients ...
Introduction: Co-administration of phenylephrine prevents oxytocin-induced hypotension during caesarean section under spinal anaesthesia (SA), but higher doses cause reflex bradycardia. This study compares the effects of co-administration of two different doses of phenylephrine on oxytocin-induced hypotension during caesarean section under SA. Methods: In this prospective, double-blind study, 90 parturients belonging to the American Society of Anesthesiologists physical status 1 or 2, undergoing caesarean section under SA were randomised into Group A: oxytocin 3U and phenylephrine 50 μg, Group B: oxytocin 3U and phenylephrine 75 μg, Group C: oxytocin 3U and normal saline, administered intravenously over 5 min after baby extraction ...
Over the period 2010-2012, maternal mortality linked to anesthesia accounted for 2% of maternal deaths, with no significant change since 2007-2009. Of the 7 maternal deaths analyzed by the expert committee, anesthetic complications were in 5 cases the main cause of death: 4 attributed to direct causes related to anesthetic procedures during childbirth and 1 to indirect cause in connection with an ENT complication during pregnancy. The anesthetic causes of maternal mortality were for the 2010-2012 period: cardiac arrest under spinal anesthesia during caesarean section, local anesthetic intoxication with unsuccessful resuscitation after cardiac arrest without intralipid administration, acute respiratory distress syndrome in the postpartum period after pulmonary aspiration during caesarean section, cardiac arrest during caesarean section under general anesthesia in a context of non-Hodgkin lymphoma with mediastinal syndrome, unsuccessful endotracheal intubation in a context of cellulitis of the ...
Andrea Cortegiani, Giuseppe Accurso, Cesare Gregoretti. Should We Use Dexmedetomidine for Sedation in Parturients Undergoing Caesarean Section Under Spinal Anaesthesia?. Turk J Anaesthesiol Reanim. 2017; 45(5): 249- ...
PubMed journal article Crystalloid Coload Reduced the Incidence of Hypotension in Spinal Anesthesia for Cesarean Delivery, When Compared to Crystalloid Preload: A Meta-Analysi were found in PRIME PubMed. Download Prime PubMed App to iPhone or iPad.
The successful dural puncture rate on first attempt (primary outcome) was higher in groups LM and UM (77 and 73% respectively) than in group UP (42%; P , 0.001). The median number of attempts was lower in groups LM and UM (1 [1] and 1 [1-1.75] respectively) than in group UP (2 [1, 2]; P , 0.001). The median number of passes was lower in groups LM and UM (2 [0.25-3] and 2 [0-4]; respectively) than in group UP (4 [2-7.75]; P , 0.001). The time taken to perform the spinal anesthesia was not different between groups LM and UM (87.24 ± 79.51 s and 116.32 ± 98.12 s, respectively) but shorter than in group UP (154.58 ± 91.51 s; P , 0.001).. ...
Spinal anesthesia is still the regional anesthesia technique most widely employed in everyday clinical practice. The most feared and common of its well known...
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METHODS: Women undergoing elective repeat cesarean section with subarachnoid anesthesia (0.5% hyperbaric bupivacaine 8-10 mg and sufentanil 5 μg) were enrolled in a double-blind, randomized study. Patients in the S-Ketamine group (N.=28) received i.v. midazolam 0.02 mg/kg and S-Ketamine 0.5 mg/kg i.m. bolus 10 minutes after birth followed by a 2 μg/kg/min i.v. continuous infusion for 12 h. The control group (N.=28) received placebo. Paracetamol and patient controlled analgesia with intravenous morphine were given postoperatively. Von Frey filaments were used to assess pain threshold on the inner forearm and T10-T11 dermatomes (supposed hyperalgesic area ...
Lidenza patch controls high blood flow pressure and muscle pain but does not cure them. In this study, we showed that this prophylactic infusion consisting of Methyl salicylate significantly prevents the muscle pain following spinal anesthesia in cesarean section than patients who had disappeared not rec
R & D department of cdc national prevention information network (npin) continues experiments focused development on treatment chlamydia. Diagnostics of chlamydia is there normally done based solely on lower abdominal incisional pain. Leading role limited in manufacturing trichomoniasis is traditionally has taken by world - known cdc national prevention and information network (npin). To help prevent chlamydia development people must himself avoid age cohort under 24. In this study, we showed that prophylactic infusion of Flagyl significantly prevents trichomoniasis following spinal anesthesia in cesarean section than seventy patients who cither had not received in any prophylactic medicine. In plating the effective product planning group eight patients had our skin rash, hives, redness, or vulvar itching. It is not a secret that multiple sexual partners can be followed generally by trichomoniasis. Diagnostics of chlamydia is normally done based on with painful urination. In clinical trials ...
PEARLS Probably the most important factor contributing to success with spinal anesthesia in the day-to-day life of an anesthesiologist is the time efficiency of the technique. Use of spinal anesthesia cannot measurably add to the surgical day if nurses and surgeons are to be co-advocates of this technique. Thus, one should plan ahead to maximize efficiency. Often overlooked in this maxim is the fact that patient preparation for the operation can begin almost as soon as the block is administered if the patient is properly sedated.. Intraoperatively, during high spinal anesthesia (often during cesarean section) patients occasionally complain excessively of dyspnea. This often appears to be a result of loss of chest wall sensation rather than of significantly decreased inspiratory capacity. The loss of chest wall sensation does not allow the patient to experience the reassurance of a deep breath. This impediment to patient acceptance can often be overcome simply by asking the patient to raise a ...
Sensei - Sensation is lost less the head and chest be lowered, before the power of motion, which The eft'ect of spinal anesthesia on may therefore persist during the an- the circulation is to produce a reduc algesia if a weak solution of the lion in the pulse rate and blood-pres anesthetic is used.
Epidural and Spinal Anesthesia are called "neuraxial anesthesia" and are commonly used for surgery, for pain relief after surgery, and for women in labor.. Epidural - An Epidural is given into your back (outside the spinal cord) by means of a very fine plastic tube, also called a catheter, which is inserted through an epidural needle (the needle is removed after the tubing is in place). Local anesthetic and other pain relieving medications are given through the tubing near the nerves in your back to decrease pain. It works by blocking the pain signals from reaching your brain. The fine plastic tube is taped onto your back and drugs can be given through this fine tube for anywhere from hours to days.. You may have a continuous slow infusion or you may be given a button to push to give yourself a dose of the pain relief medication as you need it. This is called Patient Controlled Epidural Analgesia (PCEA).. Spinal - A spinal anesthetic is performed by administering a single injection of anesthetic ...
Although there are very few investigations into the long-term effects of either type of anaesthesia, low-back pain does appear to be a major complication. A groundbreaking British study by the University of Birmingham (BMJ, 1990; 301: 9-12) showed that nearly 20 per cent of the women given epidurals during labour subsequently went on to suffer persistent low-back pain. A clue to the cause of the problem came from autopsies, where pathologists found non-specific inflammatory reactions in the spine of people who had epidurals. In many cases, there was also evidence of epidural infection (Anaesthesia, 1990; 45: 357-61 ...
Background Subarachnoid (spinal) block is a safe and effective alternative to general anesthesia when the surgical site is located on the lower extremities, perineum (eg, surgery on the genitalia or anus), or lower body wall (eg, inguinal herniorrhaphy). Because of the technical challenges of readily identifying the epidural space and the tox...
The administration of epidurals and spinal aneasthesia is common practice in maternity hospitals across Australia.. This course offers a comprehensive guide to all aspects of epidurals and spinal aneasthesia including but not limited to: pathophysiology, common medications that are used and how these medications can affect the CTG, management and expected observations of a patient with an epidural or spinal and observations. ...
Spinals are pain medications delivered via the spinal column in one dose. The medication is fast acting and can achieve a complete block of pain in as little as 15 minutes.
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Keith J Ruskin. ICISA 2017 the International Conference about Anesthesiology and Critical Care, Pain management, Neurosurgery, ICU, CPR.
To the Editor:-Protest should be entered against the apparently commercialized exploitation of the various unscientific and irrational mixtures proposed by Geor
Biology Animations includes selected, high quality biological animations; about cell biology, microbiology, genetics, immunology, cancer treatments and diagnosis.... ...
... epidural anesthesia combined with general anesthesia). *Abdominal surgery (epidural anesthesia/spinal anesthesia, often ... spinal/epidural anesthesia). *Bone and joint surgery of the pelvis, hip, and leg (spinal/epidural anesthesia, peripheral nerve ... plexus anesthesia). Spinal anesthesia and epidural anesthesia merge into the central nervous system. ... Within a few years, spinal anesthesia became widely used for surgical anesthesia and was accepted as a safe and effective ...
Drasner K. Chloroprocaine spinal anesthesia: back to the future? Anes analg 2005; 100: 549-52. ... "Comparison of bupivacaine and 2-chloroprocaine for spinal anesthesia for outpatient surgery: a double-blind randomized trial." ... Observation of Spinal Nerve Root Degeneration." Anesthesia & Analgesia 75.6 (1992): 895-899. ... It is not used in intravenous regional anesthesia due to the risk of thrombophlebitis.[citation needed] ...
ISBN 0-7817-1548-2. Tsai, Tony; Greengrass, Roy (2007). "Spinal Anesthesia". In Hadzic, Admir. Textbook of Regional Anesthesia ... Miller's Anesthesia Ch.52 Pg. 1642 Koji Kashihara (Nov 2009). "Roles of Arterial Baroreceptor Reflex During Bezold-Jarisch ... reflex has been suggested as a possible cause of profound bradycardia and circulatory collapse after spinal anesthesia. Also, ...
In 1925, Yudin published the book "Spinal Anesthesia". In 1926 this book was awarded the F.A. Rein prize by the All-Soviet ... Yudin S. Spinal anesthesia. Serpukhov: Nabat; 1922. Yudin S. A guest of American surgeons. Novi Khirurgichesky Archiv (Russian ...
People can be administered local anesthesia, a spinal block, as well as general anesthesia.[9] Local anesthesia has been shown ... "Spinal or local anesthesia in lichtenstein hernia repair: a randomized controlled trial". Annals of Surgery. 247 (3): 428-433. ... However, people who undergo general anesthesia tend to be able to go home faster and experience fewer complications.[14][15][2] ... Upon awakening from anesthesia, patients are monitored for their ability to drink fluids, produce urine, as well as their ...
He was the first to perform spinal anesthesia and intravenous regional anesthesia. After professorships in Greifswald and Bonn ... On 16 August 1898, Bier performed the first operation under spinal anesthesia at the Royal Surgical Hospital of the University ... Therefore, Bier suggested "cocainization" of the spinal cord as an alternative to general anesthesia. Bier injected 15 mg of ... Wulf, HFW (1998). "The centennial of spinal anesthesia". Anesthesiology. 89 (2): 500-6. doi:10.1097/00000542-199808000-00028. ...
The use of spinal manipulation for non-musculoskeletal is controversial. It has not been shown to be effective for asthma, ... Francis RS (2005). "Manipulation under anesthesia: historical considerations". International MUA Academy of Physicians. ... Spinal manipulation (SMT) became more popular in the 1980s. It includes manipulation and massage to "adjust" the spine and ... It is based on the teachings of B. J. Palmer, who advocated the Hole-In-One version of spinal adjustment. It is primarily used ...
Gil, K.S.L. (2013). "Chapter 12: Anesthesia for Spinal Cord Injury Surgery". In Mongan, P.D.; Soriano, S.G.; Sloan, T.B. A ... Coric, D. (2014). "Spinal technologies not available in the United States: An editorial". Neurosurgery. 61 (Supplement 1): 26- ... The prosthesis is indicated for back and leg pain caused by central or lateral spinal stenosis, degenerative disease of the ... A more comprehensive focus on re-establishing the structure and function of the human functional spinal unit may include facet ...
It is a common side-effect of spinal anesthesia and lumbar puncture and may occasionally accidentally occur in epidural ... However, very short-term use of IV hydrocortisone was found effective in reducing headache following spinal anesthesia. But, ... anesthesia. Leakage of cerebrospinal fluid through the dura mater puncture causes reduced fluid levels in the brain and spinal ... Bela I. Hatfalvi, M.D. (1977). "The dynamics of post-spinal headache". Headache. 17: 64-66. doi:10.1111/j.1526-4610.1977. ...
Either a general or a spinal anesthesia is administered. Traditionally a myomectomy is performed via a laparotomy with a full ...
... and James Leonard Corning demonstrated peridural anesthesia. 1898 saw Heinrich Quincke use cocaine for spinal anesthesia. Today ... 1935, 518, 1. Yentis SM, Vlassakov KV (1999). "Vassily von Anrep, forgotten pioneer of regional anesthesia". Anesthesiology. 90 ... In 1885, William Halsted demonstrated nerve-block anesthesia, ...
"Ultrastructure of Spinal Pia Mater." In Atlas of Functional Anatomy for Regional Anesthesia and Pain Medicine. Switzerland: ... Dura mater: farthest from the brain and spinal cord. Problems with the meninges[change , change source]. Because the meninges ... The meninges are the membranes that surround and protect the brain and the spinal cord. In mammals, the meninges have three ... The pia mater (or "pia") is the layer of the meninges that is closest to the brain and spinal cord. It is a thin, delicate ...
It is usually done under general anesthesia or spinal anesthesia. A retrograde pyelogram is done to locate the stone in the ...
Spinal anesthesia results in a blockade of the micturition reflex. Spinal anesthesia shows a higher risk of postoperative ... Anesthesia: General anesthetics during surgery may cause bladder atony by acting as a smooth muscle relaxant. General ... Tethered spinal cord syndrome Psychogenic causes (psychosocial stresses, fear associated with urination, Paruresis ("shy ... Nerve problems can occur from diabetes, trauma, spinal cord problems, stroke, or heavy metal poisoning. Medications that can ...
"Pharmacological Characterization of Noroxymorphone as a New Opioid for Spinal Analgesia". Anesthesia & Analgesia. 106 (2): 463- ... Oxycodone overdose has also been described to cause spinal cord infarction in high doses and ischemic damage to the brain, due ...
"Pharmacological Characterization of Noroxymorphone as a New Opioid for Spinal Analgesia". Anesthesia & Analgesia. 106 (2): 463- ... "Pharmacological Characterization of Noroxymorphone as a New Opioid for Spinal Analgesia". Anesthesia & Analgesia:. 106 (2): 463 ...
Marx, GF (1994). "The first spinal anesthesia. Who deserves the laurels?". Regional Anesthesia. 19 (6): 429-30. PMID 7848956. ... Although Bier properly deserves credit for the introduction of spinal anesthesia into the clinical practice of medicine, it was ... On August 16, 1898, German surgeon August Bier (1861-1949) performed surgery under spinal anesthesia in Kiel. Following the ... Wulf, HFW (1998). "The centennial of spinal anesthesia". Anesthesiology. 89 (2): 500-6. doi:10.1097/00000542-199808000-00028. ...
Sawaki, K., and Kawaguchim, M. "Some Correlations between procaine-induced convulsions and monoamides in the spinal cord of ... Vasoconstriction helps to reduce bleeding, increases the duration and quality of anesthesia, prevents the drug from reaching ... Vasoconstrictors in local anesthesia for dentistry. Anesth Prog. 1992;39:187-93. ...
For example, during any surgery on the thoracic or cervical spinal column, there is some risk to the spinal cord. Since the ... EEG measures taken during anesthesia exhibit stereotypic changes as anesthetic depth increases. These changes include complex ... or from spinal cord caudal to the surgery. This allows direct monitoring of motor tracts in the spinal cord. EEG ... A baseline is obtained, and if there are no significant changes, the assumption is that the spinal cord has not been injured. ...
"Use of a spinal Cord Stimulator for Treatment of Martorell Hypertensive Ulcer". Regional Anesthesia and Pain Medicine. 36 (1): ...
He was also a pioneer in the use of lumbar spinal anesthesia. In 1936, he was invited to address the Second International ...
It is often used to prevent low blood pressure during spinal anesthesia. It has also been used for asthma, narcolepsy, and ...
Canadian Journal of Anesthesia. 35 (3): 242-248. doi:10.1007/BF03010617. PMID 3383316. ... "Additive effects of dihydralazine during enflurane or isoflurane hypotensive anaesthesia for spinal fusion". ...
... designed for use with combined spinal epidural anesthesia. Though Ralph L. Huber (1915-2006), a Seattle dentist was the ... "The Evolution of Spinal and Epidural Needles : From the Origins to the Current". Cothon.Net. Frölich, MA; Caton, D (July 2001 ... To provide continuous epidural analgesia or anesthesia, a small hollow catheter may be threaded through the epidural needle ... Frölich, MA; Caton, D (July 2001). "Pioneers in epidural needle design". Anesthesia and Analgesia. 93 (1): 215-20. doi:10.1097/ ...
Another spinal indication for the Tessys procedure would be cauda equina syndrome, in a case where conservative methods of ... The patient remains responsive, and typically general anesthesia is not necessary. The surgeon removes the herniated disc ... This surgical method for spinal disc herniations is especially gentle for the patient. During the procedure, the patient is ... Utilizing Tessys via nature's entry point, also known as Kambin's Triangle, preserves the stability of the spinal column. The ...
In "central sensitization," nociceptive neurons in the dorsal horns of the spinal cord become sensitized by peripheral tissue ... Also, newborns who are circumcised without anesthesia have shown tendencies to react more greatly to future injections, ...
A CRNA is a licensed registered nurse who has completed additional training in anesthesia in an accredited program and is ... including diagnostic spinal taps, placement of endoscopes and insertion of bronchoscopes, "Bougie" devices and epidural ... A CRNA is authorized under regulations to administer anesthesia as part of a medical regimen and, if credentialed, may perform ... Many healthcare facilities and practices utilize certified registered nurse anesthetists (CRNAs) to administer anesthesia to ...
Examples of regional anesthesia include spinal anesthesia, epidural anesthesia, brachial plexus block anesthesia, Bier Block ... Is anesthesia safe?. Anesthesia is safer today than at any time in history. It has been estimated that a patient is more likely ... What is anesthesia?. Anesthesia is the art and science of reducing or eliminating pain. Each year, more than 26 million people ... AANA Nurse Anesthesia Annual Congress. September 21 - 25, 2018. Boston, MA. October 6, 2018. 2018 CoANA Fall Anesthesia Update ...
Depending on the anesthesia needed either the patient receives regional anesthesia such as a spinal anesthetic or a general ... place spinal anesthesia if the patient is having a Cesarean section and sometimes I have to provide general anesthesia with an ... and how does pediatric anesthesia differ from adult anesthesia and geriatric anesthesia? What goes into developing an effective ... Intra-operative anesthesia is the anesthesia the patient receives in the OR. When the patient arrives in the OR, the monitors ...
... in the lumbar spine to anesthetize nerves that exit the spinal cord. Spinal anesthesia is most commonly used for anesthesia and ... Spinal anesthesia is a type of neuraxial anesthesia; local anesthetic (LA) is injected into cerebrospinal fluid (CSF) ... in the lumbar spine to anesthetize nerves that exit the spinal cord. Spinal anesthesia is most commonly used for anesthesia and ... The Wiley Spinal Catheter-Over-Needle System for Continuous Spinal Anesthesia: A Case Series of 5 Cesarean Deliveries ...
The evolution of pediatric anesthesia and pediatric spine surgery has had a parallel trajectory and as it stands, pediatric ... Kandil A., Rao D.S., Mahmoud M. (2018) Anesthesia for Spinal Surgery in Children. In: Goudra B. et al. (eds) Anesthesiology. ... Anesthesia for orthopedic surgery. In: Gregory GA, editor. Pediatric anesthesia. New York: Churchill Livingstone; 2002. p. 617- ... Tethered spinal cord following repair of myelomeningocele. Neurosurg Focus. 2004;16(2):E7.CrossRefPubMedGoogle Scholar ...
Spinal and epidural anesthesia are procedures that deliver medicines that numb parts of your body to block pain. They are given ... Spinal, epidural, and caudal anesthesia. In: Pardo MC, Miller RD, eds. Basics of Anesthesia. 7th ed. Philadelphia, PA: Elsevier ... Spinal and epidural anesthesia are procedures that deliver medicines that numb parts of your body to block pain. They are given ... Spinal and epidural anesthesia work well for certain procedures and do not require placing a breathing tube into the windpipe ( ...
... interruption of conduction of nerve impulses by the injection of an anesthetic into the spinal canal that reduces sensitivity ... spinal anesthesia. n.. *Anesthesia produced by injection of a local anesthetic solution into the spinal subarachnoid space. ... interruption of conduction of nerve impulses by the injection of an anesthetic into the spinal canal that reduces sensitivity ...
Definition of fractional spinal anesthesia. Provided by Stedmans medical dictionary and Drugs.com. Includes medical terms and ... Synonym(s): continuous spinal anesthesia. Further information. Always consult your healthcare provider to ensure the ...
Definition of high spinal anesthesia. Provided by Stedmans medical dictionary and Drugs.com. Includes medical terms and ... high spinal anesthesia. Definition: spinal anesthesia in which the level of sensory denervation extends to the second or third ...
... and spinal anesthesia, and can occur inadvertently during epidural anesthesia. Cases of meningitis have been reported after all ... She received spinal anesthesia from anesthesiologist B and delivered a healthy baby. Approximately 15 hours after receiving the ... She received combined spinal-epidural anesthesia from anesthesiologist A, and delivered a healthy baby. Approximately 22 hours ... Two small clusters of bacterial meningitis caused by S. salivarius after spinal anesthesia occurred during 2008--2009, despite ...
Cesarean Section Cesarean Delivery Spinal Anesthesia Intrathecal Morphine Continuous Spinal Anesthesia These keywords were ... Armstrong S. (2017) Spinal Anesthesia for Cesarean Section. In: Capogna G. (eds) Anesthesia for Cesarean Section. Springer, ... Lidocaine disposition in mother, fetus, and neonate after spinal anesthesia. Anesth Analg. 1986;65(2):139-44.PubMedCrossRef ... Spinal anesthesia is technically simple to perform producing a rapid onset and dense block with a predictable offset. In this ...
Epidural and spinal blocks are types of anesthesia in which a local anesthetic is injected near the spinal cord and nerve roots ... Epidural and spinal anesthesia are used mainly for surgery of the lower belly and the legs. Epidural anesthesia is often used ... Headaches are less common with epidural anesthesia.. Epidural and spinal anesthesia are usually combined with other medicines ... Spinal anesthesia numbs the body below and sometimes above the site of the injection. The person may not be able to move his or ...
Find best Anesthesiologists for Spinal Anesthesia near you & make an appointment online instantly! Spinal Anesthesia ... Spinal Anesthesia Doctors Near You. Need to make a doctor appointment for Spinal Anesthesia this week? Use Zocdoc to find ...
Severe hypotension following spinal anesthesia in patients on amlodipine.. Parida S1, Nawaz M, Kundra P. ...
... Paediatr Anaesth. 2013 Sep;23(9):804-16. doi: 10.1111/pan.12159. Epub 2013 Apr 19. ... Spinal muscle atrophy (SMA) is autosomal recessive and one of the most common inherited lethal diseases in childhood. The ... The disease is produced by degeneration of spinal motor neurons and can be described in three or more categories: SMA I with ... Pathophysiology: The loss of full-length functioning SMN protein leads to a degeneration of anterior spinal motor neurons which ...
Effect of preoperative warming during cesarean section under spinal anesthesia.. Chung SH1, Lee BS, Yang HJ, Kweon KS, Kim HH, ... Changes in core temperature after prewarming (t = 0 min) and spinal anesthesia (t = 15 min). Data are expressed as mean. The ... Changes in arm temperature after prewarming (t = 0 min) and spinal anesthesia (t = 15 min). Data are expressed as mean. The ... Changes in leg temperature after prewarming (t = 0 min) and spinal anesthesia (t = 15 min). Data are expressed as mean. There ...
We report a case of post spinal bacterial meningitis in a post partum lady who underwent spinal anaesthesia for emergency lower ... It can occur in various settings including spinal anesthesia, diagnostic lumbar puncture, epidural anesthesia or any procedures ... Spinal anesthesia complicated by meningitis is rare. It is vital that physicians remain vigilant to detect meningitis when ... Low, Q. , Teo, K. and Cheo, S. (2018) Bacterial Meningitis Following Spinal Anesthesia for Caesarean Section. Journal of ...
... November 3rd, 2009 Medgadget Editors Anesthesiology ... Go-2 Spinal Stimulator Helps Return Leg Function: Interview with Jan Öhrström, Chairman of the Board, GTX Medical. Dexcom Moves ... Go-2 Spinal Stimulator Helps Return Leg Function: Interview with Jan Öhrström, Chairman of the Board, GTX Medical. ... The haptic device literally pushes back on the users hand so they feel surface tension as the spinal needle meets the skin; a ...
Spinal anesthesia with 12.5 mg levobupivacaine was performed in the sitting position in all women. Those in the first group ... i ,Background,/i,. The behaviour of isobaric levobupivacaine in relation to gravity when used in obstetric spinal anesthesia is ... D. W. Donielson and B. D. Palmen, "A case of reappearance of spinal anesthesia," Anesthesia and Analgesia, vol. 79, no. 4, p. ... C. Glaser, P. Marhofer, G. Zimpfer et al., "Levobupivacaine versus racemic bupivacaine for spinal anesthesia," Anesthesia and ...
These may include spinal block of varying magnitude (including total spinal block), hypotension secondary to spinal block, loss ... 14518-20 SPINAL 22G QUINCKE - regional anesthesia kit To receive this label RSS feed. Copy the URL below and paste it into your ... However, spinal and epidural anesthesia have also been reported to prolong the second stage of labor by removing the ... Epidural, spinal, paracervical, or pudendal anesthesia may alter the forces of parturition through changes in uterine ...
Spinal and epidural anesthesia are injections of liquid drugs into the area surrounding the spinal cord to cause numbness in an ...
... pediatric anesthesia, obstetric anesthesia, analgesia, clinical and experimental research, administration and efficacy, as well ... Simulation-Based Mastery Learning with Deliberate Practice Improves Clinical Performance in Spinal Anesthesia. Ankeet D. Udani, ... Comment on "Simulation-Based Mastery Learning with Deliberate Practice Improves Clinical Performance in Spinal Anesthesia", ... "Simulation-Based Mastery Learning with Deliberate Practice Improves Clinical Performance in Spinal Anesthesia," Anesthesiology ...
... anesthesia spinal include Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular ... Anesthesia, Spinal: Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach. ...
Combination spinal-epidural anesthesia is a regional anesthesia technique used in many orthopedic procedures below the waist. ... In this procedure, your anesthesiologist will use the same small needle to enter the fluid surrounding the spinal cord but will ... Patients often have no recollection of undergoing a spinal or epidural. Once sedated, your anesthesiologist will either sit you ... For shorter procedures, a stand-alone spinal is performed. ... needle into the fluid which normally surrounds the spinal cord ...
Prophylactic Mirtazapine or Clonidine for Post-spinal Anesthesia Shivering. The safety and scientific validity of this study is ... Prophylactic Mirtazapine or Clonidine for Post-spinal Anesthesia Shivering in Patients Undergoing Urological Surgeries: a ... underwent urological surgeries under spinal anesthesia. A written informed consent was obtained from all patients to ... Total participants received pethidine for treatment of post-spinal shivering in the three groups till 20 minutes after the end ...
  • A CRNA is a licensed registered nurse who has completed additional training in anesthesia in an accredited program and is certified by a national organization to give anesthesia to patients. (mlmic.com)
  • A CRNA is authorized under regulations to administer anesthesia as part of a medical regimen and, if credentialed, may perform a variety of functions under the supervision of a physician, including diagnostic spinal taps, placement of endoscopes and insertion of bronchoscopes, "Bougie" devices and epidural catheters. (mlmic.com)
  • As Assistant Chief CRNA, Dr. Clark provides general, regional, and peripheral anesthesia to pediatric, adult, and obstetrical patients, while also completing administrative duties such as coordinating improvements to policies and procedures, overseeing the tasks of anesthesia staff, and managing continuing education sessions for CRNAs at the Medical Center. (onlinefnpprograms.com)
  • In addition to her clinical and staff leadership, Dr. Clark has an extensive background in nurse anesthesia education, having served as a Clinical Coordinator during her time at UC Davis Medical Center, as a Clinical Preceptor for Samuel Merritt University CRNA students, and as Assistant Professor and Co-Chairperson for the Admission Committee at Samuel Merritt University's Program of Nurse Anesthesia. (onlinefnpprograms.com)
  • My first job as a CRNA was at the University of California- Davis Medical Center (UCDMC) in Sacramento, CA. I was the clinical coordinator for the SMU PNA students at UCDMC and became a preceptor to nurse anesthesia students in the operating room (OR). (onlinefnpprograms.com)
  • Many healthcare facilities and practices utilize certified registered nurse anesthetists (CRNAs) to administer anesthesia to patients. (mlmic.com)
  • Dr. Clark earned her BSN from the University of Wisconsin-Milwaukee in 1986, her MSN with a concentration in Nurse Anesthesia in 1997 from Samuel Merritt University, and her DNP in Leadership and Education in 2012 from Rush University. (onlinefnpprograms.com)
  • OnlineFNPPrograms.com] Could we please have an overview of your professional and academic path in nurse anesthesia? (onlinefnpprograms.com)
  • I knew I needed the experience in critical care as well as emergency room in order to apply to the Program of Nurse Anesthesia (PNA) at Samuel Merritt University (SMU) in Oakland, CA. Additional requirements for the SMU PNA were: BSN, grade point average (GPA) of 3.5 or higher, proof of leadership ability, the graduate record exam, reference letters, and basic life support (BLS) and advanced cardiac life support (ACLS) certification. (onlinefnpprograms.com)
  • In spinal anesthesia muscles are relaxed and there is usually less blood loss than with other methods.It reflects the average number of citations to recent articles published in science and social science journals in a particular year or period, and is frequently used as a proxy for the relative importance of a journal within its field. (omicsonline.org)
  • The Accuro uses proprietary software to automate spinal landmark detection and depth measurements and to assess scan plane orientation in 3-D. Preliminary reports suggest that the Accuro allows accurate identification of spinal anatomy, compares favorably to the manual landmark and 2-D ultrasound methods when used to determine the depth to the epidural space, and is easier to learn and effectively use than conventional 2-D ultrasound (Tiouririne et al. (ecri.org)
  • The aim of this study was to assess the prevalence of spinal anesthesia use, attitude of mothers towards spinal anesthesia, and magnitude of its complications.Methods: This is a hospital-based cross-sectional study conducted from April-June 2014 at Tikur Anbessa Specialized Hospital and Gandhi Memorial Hospital, Addis Ababa, Ethiopia. (who.int)
  • Anesthesia is a field of study that involves methods of removing sensation, pain, and consciousness from a person in order to perform surgeries, do other uncomfortable procedures, or relieve his pain/suffering. (healthtap.com)
  • METHODS: We induced spinal anesthesia in 80 young men presenting for elective orthopedic surgery. (koreamed.org)
  • Methods: Hemodynamic data, frequencies of either high or total spinal block, and maternal and neonatal outcome data were gathered from the anesthesia records of all parturients at the Amphia Hospital, undergoing intrapartum CD between January 1, 2001 and May 1, 2005. (eur.nl)
  • Purpose: Failed conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum Cesarean delivery (CD) has been observed in clinical practice. (eur.nl)
  • The objective of this report was to describe the case of a hematoma after spinal anesthesia treated conservatively, and review the literature. (scielo.br)
  • Newswise - San Francisco, CA. (February 27, 2013) - During the first stage of labor, a combined spinal-epidural (CSE) technique offers faster and better-quality analgesia (pain relief) compared to traditional epidural analgesia, according to a report in the March issue of Anesthesia & Analgesia , official journal of the International Anesthesia Research Society (IARS). (iars.org)
  • The International Anesthesia Research Society is a nonpolitical, not-for-profit medical society founded in 1922 to advance and support scientific research and education related to anesthesia, and to improve patient care through basic research. (iars.org)
  • In the past, it has been understandably concluded that spinal anesthesia might cause Restless Leg Syndrome (RLS), or that existing RLS could be worsened by the use of it. (hellolife.net)
  • The evolution of pediatric anesthesia and pediatric spine surgery has had a parallel trajectory and as it stands, pediatric spine surgery has cemented itself as a cornerstone of most pediatric anesthesia practices. (springer.com)
  • Twenty-four hours later, saddle anesthesia and lumbar pain persisted and, after 48 hours, the patient presented urinary incontinence. (scielo.br)
  • Veinte y cuatro horas después de la realización del bloqueo el paciente permanecía con anestesia en silla de montar y con dolor lumbar, y 48 horas después del procedimiento presentó una incontinencia urinaria. (scielo.br)