Document Detail


Epidural spread of iohexol following the use of air or saline in the 'loss of resistance' test.
MedLine Citation:
PMID:  21040376     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To compare, using CT epidurography, the cranial distribution of contrast after epidural injection when saline or air is used for the loss of resistance (LOR) technique in identifying the epidural space.
STUDY DESIGN: Prospective, randomized, cross-over experimental study.
ANIMALS: Nine healthy adult Beagle dogs.
METHODS: Under general anaesthesia, a spinal needle (22-gauge, 70 mm) was inserted through the lumbosacral space, and the position in the epidural space confirmed using the LOR technique employing either 0.3 mL per dog of saline or of air. Epidurography using CT was performed before and 5, 10 and 20 minutes after epidural injection of 0.2 mL kg(-1) of iohexol. The cranial distribution of iohexol was recorded as the number of vertebral segments reached from the seventh lumbar vertebrae.
RESULTS: The median values in vertebral segments of the cranial distribution at 5, 10 and 20 minutes after epidural injection were 19.5, 20.5 and 21.0 respectively with the saline treatment, and 12.0, 15.0 and 16.0 respectively in the air treatment. At all time points spread of contrast was significantly less with the air treatment. All dogs after air treatment had some air bubbles in the epidural space, and in seven, the spinal cord was moderately compressed by the air. No neurological complications were observed after recovery.
CONCLUSIONS AND CLINICAL RELEVANCE: The use of air for the LOR technique is associated with significantly less spread, uneven cranial distribution of the contrast medium and compression of the spinal cord. It is recommended that saline, and not air, should be used to identify the epidural space by this method.
Authors:
Toshie Iseri; Ryohei Nishimura; Shotaro Nagahama; Manabu Mochizuki; Takayuki Nakagawa; Yuka Fujimoto; Di Zhang; Nobuo Sasaki
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Veterinary anaesthesia and analgesia     Volume:  37     ISSN:  1467-2995     ISO Abbreviation:  Vet Anaesth Analg     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100956422     Medline TA:  Vet Anaesth Analg     Country:  England    
Other Details:
Languages:  eng     Pagination:  526-30     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Veterinary Anaesthesia and Analgesia © 2010 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.
Affiliation:
Laboratory of Veterinary Surgery, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan.
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