Abstract
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(1)
The spread of epidural analgesia following injection of 15 ml of 2% mepivacaine was 17.3 ± 0.6, 14.3 ± 0.4, and 13.3 ± 0.7 spinal segments in cervical, thoracic, and lumbar epidural analgesia, respectively. The patient’s age showed significant correlation with the spread of epidural analgesia in cervical (r=0.5776., p<O.OO1), thoracic (r=0.3758, p<O.01), and lumbar area (r=0.8195, p<O.OO1). The spread of cervical epidural analgesia was more caudad than cephalad (p<0.05), but in lumbar epidural analgesia it was more cephalad than caudad (p<0.05). There was no difference between the cephalad and caudad spread in thoracic epidural analgesia.
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(2)
The epidural pressure immediately after injection of 15 ml of 2% mepivacaine into the lumbar epidural space at a constant pressure (80 mmHg) correlated to the patient’s age (r=-0.5714, p<O.OO1)and the spread of analgesia (r=-0.3904, p<0.05). The lower epidural pressure associated with higher age, the wider spread of analgesia. There was no significant correlation between the residual pressure at 60 seconds and the age or the spread of analgesia.
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Usubiaga JE, Wikinski JA, Usubiaga LE: Epidural pressure and its relation to spread anesthetic solutions in epidural space. Anesthesia and Analgesia 46:440–446, 1967
Husemeyer RP, White DC: Lumbar extradual injection pressures and extent of analgesia. Br J gation of relationships between rate of injection, injection pressures and extent of analgesia. Br J Anaesth 52:55–60, 1980
Matsuda I: Identification of epidural space using a drip infusion set. Masui (Jpn J Anesth) 26:956957, 1977
Cousins MJ: Epidural neural blockade, neural blockade, in clinical anesthesia & management of pain. Edited by Cousins MJ and Bridenbaugh PO. Philadelphia, Lippincott, 1980, p262
Nishimura N, Kitahara T, Kusakabe T: The spread of lidocaine and 1-13I solution in the epidural space. Anesthesiology 20:785–788, 1959
Bromage PR: Ageing and epidural dose reqirements, segmental spread and predictability of epidural analgesia in youth and extreme age. Br J Anaesth 41:1016–1022, 1969
Park WY, Hagins FM, Rivat EL, Macnamara TE: Age and epidural dose response in adult men. Anesthesiology 56:318–320, 1982
Nishimura N, Endou M: Epidural residual pressure and spread of analgesia in epidural anesthesia. Masui(Jpn J Anesth) 33:956–982, 1984
Shantha TR, Evans JA: The relationship of epidural anesthesia to neural membranes and arachnoid villi. Anesthesiology 37:543 -557, 1972
Bromage PR: Epidural compliance, Epidural Analgesia. Edited by Bromage PR. Philadelphia, WB Saunders, 1978, pp 171–175
Pitkin WM: Extradual anesthesia, conduction anesthesia. Edited by Southworth JL, Hingson RA, Pitkin WM. Philadelphia, JB Lippincott, 1953, pp 728–784
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Hirabayashi, Y., Matsuda, I., Inoue, S. et al. Spread of epidural analgesia following a constant pressure injection. J Anesth 1, 44–50 (1987). https://doi.org/10.1007/s0054070010044
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DOI: https://doi.org/10.1007/s0054070010044