Disease relevance of Anesthesia, Spinal

• Prevention of hypotension during spinal anesthesia for cesarean delivery: an effective technique using combination phenylephrine infusion and crystalloid cohydration [1].
• BACKGROUND: Hyperbaric 5% lidocaine has been associated with transient neurologic symptoms (TNSs) after spinal anesthesia [2].
• None of the patients who received spinal anesthesia without ketamine sedation developed postoperative bradycardia, prolonged apnea, or periodic breathing [3].
• Spinal epidural hematoma after spinal anesthesia in a patient treated with clopidogrel and enoxaparin [4].
• Effects of alpha adrenergic blockade, combined nicotinic and muscarinic ganglion blockade and spinal anesthesia upon norepinephrine depression of ganglion transmission in the dog [5].

Psychiatry related information on Anesthesia, Spinal

• Sixty patients undergoing transurethral procedures were randomly assigned in a double blind design to receive i.v. either 3 ml normal saline (N/S group, n = 20), or 150 micrograms fentanyl (F group, n = 20), or 40 mg tenoxicam (T group, n = 20), 20 minutes after spinal anesthesia [6].
• Sensory thresholds to electrical stimulation were measured at the S1, L1, T10, and T5 levels before injection, after spinal anesthesia, and after the addition of epidural anesthesia [7].

High impact information on Anesthesia, Spinal

• Spinal anesthesia and mini-dose heparin [8].
• Spinal anesthesia in obstructive cardiomyopathy [9].
• The disappearance of continuous muscle discharges during spinal anesthesia and the lack of response to diazepam indicated generation of the discharges from the proximal portion of the motor unit [10].
• The degree of impairment was directly related to serum anticholinergic activity levels and, in the small subgroup of patients scheduled for spinal anesthesia, to CSF anticholinergic activity [11].
• Nimodipine, a calcium entry blocker, was administered in increasing doses of 0.1-3.0 micrograms kg-1 min-1 to six dogs after they had recovered consciousness from a surgical preparation that was conducted under general anesthesia and while they were under the influence of total spinal anesthesia [12].

Chemical compound and disease context of Anesthesia, Spinal

• BACKGROUND: Recent evidence suggests that transient neurologic symptoms (TNSs) frequently follow lidocaine spinal anesthesia but are infrequent with bupivacaine [13].
• The addition of phenylephrine contributes to the development of transient neurologic symptoms after spinal anesthesia with 0.5% tetracaine [14].
• The present study sought to determine whether the presence of phenylephrine or the concentration of glucose in the anesthetic solution affects the incidence of transient neurologic symptoms after spinal anesthesia with 0.5% tetracaine [14].
• Transient neurologic symptoms after spinal anesthesia: a lower incidence with prilocaine and bupivacaine than with lidocaine [13].
• Respiratory depression with addition of fentanyl to spinal anesthesia [15].

Biological context of Anesthesia, Spinal

• Significant decreases in magnesium (Mg) concentration and alkaline phosphatase (ALP, EC 3.1.3.1) activity in serum were seen in patients after cardiac surgery with cardiopulmonary bypass (Group 1), as compared with non-cardiac-surgery patients after general anesthesia (Group 2) or only spinal anesthesia (Group 3) [16].
• To elucidate the biochemical mechanisms of spinal anesthesia, we studied the effects of procaine and tetracaine on protein phosphorylation in the mouse spinal cord [17].
• CONCLUSION: These results suggest that norepinephrine enhances inhibitory synaptic transmission in the substantia gelatinosa through activation of presynaptic alpha1 receptors, thus providing a mechanism underlying the clinical use of alpha1 agonists with local anesthetics in spinal anesthesia [18].
• beta2-adrenoceptor genotype affects vasopressor requirements during spinal anesthesia for cesarean delivery [19].
• Significantly less lidocaine was needed (P less than 0.05) for comparable segmental levels of spinal anesthesia in term and postpartum patients than in nonpregnant individuals [20].

Anatomical context of Anesthesia, Spinal

• Cerebrospinal fluid samples from 44 pregnant women undergoing spinal anesthesia for delivery were studied to determine whether an abdomen distended with a full-term fetus could alter the dynamics of lumbar CSF [21].
• BACKGROUND: Delivery of large doses of local anesthetics for spinal anesthesia by repeated injections or continuous infusion could expose the cauda equina to concentrations of drug that may be neurotoxic per se [22].
• The increase in duration of spinal anesthesia with clonidine may be related to a direct post-synaptic alpha 2 adrenoceptor arteriolar effect, a spinal cord pre- or post-synaptic alpha 2 antinociceptive action or supraspinal alpha 2 modulation of nociception [23].
• METHODS: Three milliliters (15 mg) of hyperbaric bupivacaine, 0.5%, was injected intrathecally in 40 patients classified as American Society of Anesthesiologists physical status I or H scheduled for lower limb surgery during spinal anesthesia [24].
• We studied this possible neurotoxic effect by assessing recovery from conduction blockade of desheathed peripheral nerves after exposure to some of the local anesthetic solutions commonly used for spinal anesthesia [22].

Associations of Anesthesia, Spinal with chemical compounds

• In eight patients undergoing similar operations during low spinal anesthesia, no inhibition of the AIR to glucose occurred, and plasma NE and Epi did not increase significantly during or after the operation [25].
• Thirty otherwise healthy patients received a 100-mg oral dose of chlordiazepoxide HCl just prior to surgical procedures using spinal anesthesia [26].
• Each patient was studied before, during, and after bupivacaine-induced spinal anesthesia (mean sensory block: T4) [27].
• METHODS: The number of patients to be enrolled (100 per group) was determined by power analysis (80%, P = 0.05) considering an incidence of TNSs after spinal anesthesia with lidocaine of at least 11% according to data reported in other studies [2].
• Spinal anesthesia using tetracaine has been reported to produce a decrease in plasma catecholamine concentrations [28].

Gene context of Anesthesia, Spinal

• RESULTS: Both plasma and CSF levels of IL-6 increased substantially after major surgery with either general or spinal anesthesia [29].
• Neither halothane nor combined halothane/spinal anesthesia had any effect on the interleukin-6 stress response in the absence of surgical stress [30].
• METHODS: CSF was collected from preeclamptic patients (n=15) and controls (n=7) at the time of spinal anesthesia and assayed for PlGF, sFlt-1, and VEGF (total and free) by specific immunoassays [31].
• METHODS: Six male volunteers participated on three consecutive study days: epidural or spinal anesthesia were randomly assigned on the 1st and 3rd days (approximately T10 level); no anesthesia was given on the 2nd day [32].
• We studied the effects of intrathecal LY293558, a competitive non-N-methyl-D-aspartate excitatory amino acid receptor antagonist, on motor and sensory function in rats to determine whether drugs blocking these receptors could potentially be used as alternative agents to local anesthetics for spinal anesthesia [33].

Analytical, diagnostic and therapeutic context of Anesthesia, Spinal

• Phenylephrine added to prophylactic ephedrine infusion during spinal anesthesia for elective cesarean section [34].
• This may be a mechanism by which spinally administered epinephrine enhances the duration or intensity of spinal anesthesia produced by local anesthetics and may also explain spinal analgesia resulting from the spinal administration of adrenergic agonists [35].
• BACKGROUND: Small doses of bupivacaine may be a reasonable choice for spinal anesthesia for patients having ambulatory surgery [36].
• DISCUSSION: Premedication with oral clonidine prolonged sensory and motor block from lidocaine spinal anesthesia [37].
• Oral clonidine prolongs lidocaine spinal anesthesia in human volunteers [37].

References