Regional anesthesia
-
Regional anesthesia · Jan 1991
Anatomic spread of india ink in the human intercostal space with radiographic correlation.
In a study designed to determine the spread of anesthetic solutions in the intercostal space, the spread of india ink was studied in fresh cadavers. They were turned prone and had epidural catheters placed at ribs 4, 6, 8 and 10, 7-8 cm lateral to the midline, by two different techniques. Group 1 had epidural catheters directed laterally into the subcostal groove. ⋯ Posteroanterior and lateral radiographs taken with contrast material in live patients confirmed these patterns of spread. The catheters in Groups 1 and 2 were within the same tissue plane. The results indicate that the pattern of spread obtained by injection of fluid in the intercostal space is dependent upon the site of injection in relation to the angle of the rib.
-
Epidural abscess is a neurologic emergency. Diagnosis may be difficult and costly to patients and health care providers in terms of time and money expended. ⋯ Diagnostic studies were performed that documented the presence of a spinal epidural abscess. Routine aspiration of an implanted epidural catheter facilitated the early diagnosis of epidural abscess in our patient prior to the performance of these studies.
-
Regional anesthesia · Jan 1991
Vertebral column length and spread of hyperbaric subarachnoid bupivacaine in the term parturient.
Patient height is considered an important determinant of the dose of spinal anesthesia. However, the relationship between body height and the level of sensory anesthesia with a fixed dose of spinal anesthetic has not been clearly documented. Recent evidence suggests no correlation between height or weight of parturients and spread of spinal anesthesia. ⋯ We studied the correlation between vertebral length measured from C7 to the level of the iliac crest (IC) and to the sacral hiatus (SH) and the sensory anesthetic level after the subarachnoid administration of 12 mg hyperbaric bupivacaine in term pregnant patients. There was no correlation between patient height, weight or body mass index and sensory anesthesia level. However, a significant correlation existed between vertebral length measured from C7 to IC (r = 0.32, p = 0.025) or to SH (r = 0.38, p = 0.006) and the level of anesthesia.