PubMed · 2400434
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
N Weksler, L Ovadia. 1990. Postspinal headache.. https://doi.org/10.1111/j.1365-2044.1990.tb14800.x
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
PURPOSE: This study examined in an animal model whether intrathecal midazolam, alone or with fentanyl, can achieve anaesthesia sufficient for laparotomy, comparable to lidocaine. Effects on consciousness and whether anaesthesia was segmental were also examined. The haemodynamic and respiratory changes were compared with those of intrathecal lidocaine or intrathecal fentanyl alone. METHODS: Sixty Wistar strain rats, with nylon catheters chronically implanted in the lumbar subarachnoid theca, were divided into six groups. Group 1 (n = 12) received 75 microL intrathecal lidocaine 2%. Group 2 (n = 12) received 75 microL intrathecal midazolam 0.1%, Group 3 (n = 12) received intrathecal 37.5 microL midazolam 0.1%, plus 37.5 microL fentanyl 0.005%. Group 4 (n = 12) received intrathecal 50 microL fentanyl 0.005%. Group 5 (n = 6) received 75 microL midazolam 0.1% iv. Group 6 (n = 6) received halothane 0.6% in oxygen by inhalation. RESULTS: Both groups that received intrathecal midazolam, alone or combined with fentanyl, developed effective segmental sensory and motor blockade of the hind limbs and abdominal wall, sufficient for a pain-free laparotomy procedure. Neither of these groups, unlike the group that received intrathecal lidocaine, developed a reduction in blood pressure or change in heart rate at the time of maximal sensory or motor blockade, nor were there changes in the arterial blood gases or respiratory rate. CONCLUSION: Midazolam, when injected intrathecally, produces reversible, segmental, spinally mediated antinociception, sufficient to provide balanced anaesthesia for abdominal surgery.
Continuous spinal anaesthesia (CSA) is a further means of central nerve block for anaesthesia besides single-shot spinal (SSS), combined spinal/epidural, and epidural anaesthesia. Major advantages compared to SSS are the possibility of subsequent injection of local anaesthetic via the indwelling catheter, which enables analgesia to be maintained over a longer period. Moreover, the haemodynamic effects are diminished by this mode of application. The most important advantages of CSA compared to continuous epidural anaesthesia are the more rapid onset of action, better quality of analgesia, and better muscle relaxation. Since small doses of local anaesthetic are used in CSA, there is less danger of systemic toxic reactions. The microcatheters used up to now for CSA are introduced via relatively large needles that cause perforation trauma to the dura, resulting in loss of cerebrospinal fluid (CSF) and thus a higher incidence of post-dural punctive headache. Hence, further technical developments must have the objectives of reducing needle diameter and increasing catheter diameter. Perforation trauma to the dura is reduced by using small needles. Use of a larger catheter enables better mixing of the local anaesthetic with the CSF, and it is easier to aspirate CSF in order to establish the correct position of the catheter.