schliessen

Filtern

 

Bibliotheken

Technical aspects and postoperative sequelae of spinal and epidural anesthesia: A prospective study of 3,230 orthopedic patients

Background and Objectives: Major complications after spinal or epidural anesthesia are extremely rare. The occurrence of less serious and transient sequelae and complaints may be underestimated if there is no established organization for the systematic and continuous surveillance of patients after a... Full description

Journal Title: Regional anesthesia and pain medicine 2000-09, Vol.25 (5), p.488-497
Main Author: Puolakka, Risto
Other Authors: Haasio, Juhani , Pitkänen, Mikko T , Kallio, Markku , Rosenberg, Per H
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Inc
ID: ISSN: 1098-7339
Link: https://www.ncbi.nlm.nih.gov/pubmed/11009234
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: cdi_proquest_miscellaneous_72296255
title: Technical aspects and postoperative sequelae of spinal and epidural anesthesia: A prospective study of 3,230 orthopedic patients
format: Article
creator:
  • Puolakka, Risto
  • Haasio, Juhani
  • Pitkänen, Mikko T
  • Kallio, Markku
  • Rosenberg, Per H
subjects:
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Epidural - adverse effects
  • Anesthesia, Spinal - adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures
  • Postoperative Complications - etiology
  • Prospective Studies
ispartof: Regional anesthesia and pain medicine, 2000-09, Vol.25 (5), p.488-497
description: Background and Objectives: Major complications after spinal or epidural anesthesia are extremely rare. The occurrence of less serious and transient sequelae and complaints may be underestimated if there is no established organization for the systematic and continuous surveillance of patients after anesthesia. This study was designed to evaluate the possible relationship between various block-related occurrences and the intra- and postoperative side effects and complaints. Methods: This prospective study included 3,230 orthopedic patients operated on under neuraxial block. The block was performed by single-dose (single-shot spinal anesthesia [SPIN], 80.6%), continuous spinal anesthesia (CSA, 10.3%), or combined spinal and epidural anesthesia (CSE, 9.1%) technique. The patient position during surgery and a detailed description of block performance and equipment, as well as all intraoperative problems, were immediately recorded. Every patient was given a standardized questionnaire to be completed and returned after 1 week. Results: The overall incidence of paresthesia was 12.8%, being most frequent during spinal catheter insertion with multiple attempts. Postoperative sensory disturbances (numbness, dysesthesia) occurred unrelated to paresthesia elicited by the puncture or catheterization. The failure rates (SPIN, 1.0%; CSA, 1.5%; and CSE, 1.0%) were quite low. Asystole with successful resuscitation, occurred in 1 patient with CSE but, overall, hemodynamic perturbations were more common with the continuous techniques. On the first postoperative day, decreased sensation of the skin was significantly more frequent after the continuous techniques, still present in 6.5% of SPIN patients, 6.1% of CSA patients, and 17.2% of CSE patients 1 week after surgery. These disturbances were also related to the use of a tourniquet and lateral position of the patient during surgery. The frequency of postdural puncture headache (PDPH) was similar for the different techniques (SPIN, 0.9%; CSA, 1.5%; and CSE, 1.7%). About one third of the patients reported strong postoperative pain on the day after the operation, and 5.6% continued to report this at 1 week. Conclusions: Although sensory changes were quite frequent, they were mild and transient. Rather than having been caused by the anesthetic technique, per se, a “nonanesthetic” reason (position, tourniquet, immobilization) should also be considered as their origin. Sensory disturbances, as well as strong pain for at least a wee
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1098-7339
fulltext: fulltext
issn:
  • 1098-7339
  • 1532-8651
url: Link


@attributes
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
RANK1.9922477
LOCALfalse
PrimoNMBib
record
control
sourceidproquest_cross
recordidTN_cdi_proquest_miscellaneous_72296255
sourceformatXML
sourcesystemPC
sourcerecordid60967468
originalsourceidFETCH-LOGICAL-c313t-f9a276810d910f1d7100afee2883d4d74de07c416ac5358f3be9a1e5f1feab1d3
addsrcrecordideNp1kc2LFDEQxYMo7rp69SjBgyd7zEenk_a2LH7Bgpf1HDJJhcnSMx2T9MLe9k-3emZAEDylAr961HuPkLecbThT8lNxeb8RjLGNHph-Ri65kqIzg-LPcWaj6bSU4wV5Ves9Ukb3w0tywTljo5D9JXm6A787JO8m6moG3yp1h0DzXNucobiWHoBW-L3A5IDOkdacDiuMEOQUlnL8QG07qMl9ptc0l_modNxsS3hc1-RHIRmdS9uhbEieZpSGQ6uvyYvopgpvzu8V-fX1y93N9-7257cfN9e3nZdcti6OTujBcBZGziIPGh24CCCMkaEPug_AtO_54LySykS5hdFxUJFHcFse5BX5cNLF89BNbXafqodpwuPnpVotxDgIpRB8_w94Py8FPVcrmOIDBmcQ2pwgj2ZrgWhzSXtXHi1ndi3GrsXYtRi7FoML786qy3YP4S9-bgIBcwIAQ3hIUGz1GJDHsAqGacOc_qf9B_WFnkI
sourcetypeAggregation Database
isCDItrue
recordtypearticle
pqid205160928
display
typearticle
titleTechnical aspects and postoperative sequelae of spinal and epidural anesthesia: A prospective study of 3,230 orthopedic patients
sourceAlma/SFX Local Collection
creatorPuolakka, Risto ; Haasio, Juhani ; Pitkänen, Mikko T ; Kallio, Markku ; Rosenberg, Per H
creatorcontribPuolakka, Risto ; Haasio, Juhani ; Pitkänen, Mikko T ; Kallio, Markku ; Rosenberg, Per H
descriptionBackground and Objectives: Major complications after spinal or epidural anesthesia are extremely rare. The occurrence of less serious and transient sequelae and complaints may be underestimated if there is no established organization for the systematic and continuous surveillance of patients after anesthesia. This study was designed to evaluate the possible relationship between various block-related occurrences and the intra- and postoperative side effects and complaints. Methods: This prospective study included 3,230 orthopedic patients operated on under neuraxial block. The block was performed by single-dose (single-shot spinal anesthesia [SPIN], 80.6%), continuous spinal anesthesia (CSA, 10.3%), or combined spinal and epidural anesthesia (CSE, 9.1%) technique. The patient position during surgery and a detailed description of block performance and equipment, as well as all intraoperative problems, were immediately recorded. Every patient was given a standardized questionnaire to be completed and returned after 1 week. Results: The overall incidence of paresthesia was 12.8%, being most frequent during spinal catheter insertion with multiple attempts. Postoperative sensory disturbances (numbness, dysesthesia) occurred unrelated to paresthesia elicited by the puncture or catheterization. The failure rates (SPIN, 1.0%; CSA, 1.5%; and CSE, 1.0%) were quite low. Asystole with successful resuscitation, occurred in 1 patient with CSE but, overall, hemodynamic perturbations were more common with the continuous techniques. On the first postoperative day, decreased sensation of the skin was significantly more frequent after the continuous techniques, still present in 6.5% of SPIN patients, 6.1% of CSA patients, and 17.2% of CSE patients 1 week after surgery. These disturbances were also related to the use of a tourniquet and lateral position of the patient during surgery. The frequency of postdural puncture headache (PDPH) was similar for the different techniques (SPIN, 0.9%; CSA, 1.5%; and CSE, 1.7%). About one third of the patients reported strong postoperative pain on the day after the operation, and 5.6% continued to report this at 1 week. Conclusions: Although sensory changes were quite frequent, they were mild and transient. Rather than having been caused by the anesthetic technique, per se, a “nonanesthetic” reason (position, tourniquet, immobilization) should also be considered as their origin. Sensory disturbances, as well as strong pain for at least a week, were reported by several patients, and to become aware of these problems and improve the quality of treatment, a universal regional anesthesia follow-up system is recommended. Reg Anesth Pain Med 2000;25:488-497.
identifier
0ISSN: 1098-7339
1EISSN: 1532-8651
2DOI: 10.1053/rapm.2000.7607
3PMID: 11009234
languageeng
publisherEngland: Elsevier Inc
subjectAdolescent ; Adult ; Aged ; Aged, 80 and over ; Anesthesia, Epidural - adverse effects ; Anesthesia, Spinal - adverse effects ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; Postoperative Complications - etiology ; Prospective Studies
ispartofRegional anesthesia and pain medicine, 2000-09, Vol.25 (5), p.488-497
rights
02000 American Society of Regional Anesthesia and Pain Medicine
1Copyright Churchill Livingstone Inc., Medical Publishers Sep/Oct 2000
lds50peer_reviewed
links
openurl$$Topenurl_article
openurlfulltext$$Topenurlfull_article
thumbnail$$Usyndetics_thumb_exl
backlink$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11009234$$D View this record in MEDLINE/PubMed
search
creatorcontrib
0Puolakka, Risto
1Haasio, Juhani
2Pitkänen, Mikko T
3Kallio, Markku
4Rosenberg, Per H
title
0Technical aspects and postoperative sequelae of spinal and epidural anesthesia: A prospective study of 3,230 orthopedic patients
1Regional anesthesia and pain medicine
addtitleReg Anesth Pain Med
descriptionBackground and Objectives: Major complications after spinal or epidural anesthesia are extremely rare. The occurrence of less serious and transient sequelae and complaints may be underestimated if there is no established organization for the systematic and continuous surveillance of patients after anesthesia. This study was designed to evaluate the possible relationship between various block-related occurrences and the intra- and postoperative side effects and complaints. Methods: This prospective study included 3,230 orthopedic patients operated on under neuraxial block. The block was performed by single-dose (single-shot spinal anesthesia [SPIN], 80.6%), continuous spinal anesthesia (CSA, 10.3%), or combined spinal and epidural anesthesia (CSE, 9.1%) technique. The patient position during surgery and a detailed description of block performance and equipment, as well as all intraoperative problems, were immediately recorded. Every patient was given a standardized questionnaire to be completed and returned after 1 week. Results: The overall incidence of paresthesia was 12.8%, being most frequent during spinal catheter insertion with multiple attempts. Postoperative sensory disturbances (numbness, dysesthesia) occurred unrelated to paresthesia elicited by the puncture or catheterization. The failure rates (SPIN, 1.0%; CSA, 1.5%; and CSE, 1.0%) were quite low. Asystole with successful resuscitation, occurred in 1 patient with CSE but, overall, hemodynamic perturbations were more common with the continuous techniques. On the first postoperative day, decreased sensation of the skin was significantly more frequent after the continuous techniques, still present in 6.5% of SPIN patients, 6.1% of CSA patients, and 17.2% of CSE patients 1 week after surgery. These disturbances were also related to the use of a tourniquet and lateral position of the patient during surgery. The frequency of postdural puncture headache (PDPH) was similar for the different techniques (SPIN, 0.9%; CSA, 1.5%; and CSE, 1.7%). About one third of the patients reported strong postoperative pain on the day after the operation, and 5.6% continued to report this at 1 week. Conclusions: Although sensory changes were quite frequent, they were mild and transient. Rather than having been caused by the anesthetic technique, per se, a “nonanesthetic” reason (position, tourniquet, immobilization) should also be considered as their origin. Sensory disturbances, as well as strong pain for at least a week, were reported by several patients, and to become aware of these problems and improve the quality of treatment, a universal regional anesthesia follow-up system is recommended. Reg Anesth Pain Med 2000;25:488-497.
subject
0Adolescent
1Adult
2Aged
3Aged, 80 and over
4Anesthesia, Epidural - adverse effects
5Anesthesia, Spinal - adverse effects
6Female
7Humans
8Male
9Middle Aged
10Orthopedic Procedures
11Postoperative Complications - etiology
12Prospective Studies
issn
01098-7339
11532-8651
fulltexttrue
rsrctypearticle
creationdate2000
recordtypearticle
recordideNp1kc2LFDEQxYMo7rp69SjBgyd7zEenk_a2LH7Bgpf1HDJJhcnSMx2T9MLe9k-3emZAEDylAr961HuPkLecbThT8lNxeb8RjLGNHph-Ri65kqIzg-LPcWaj6bSU4wV5Ves9Ukb3w0tywTljo5D9JXm6A787JO8m6moG3yp1h0DzXNucobiWHoBW-L3A5IDOkdacDiuMEOQUlnL8QG07qMl9ptc0l_modNxsS3hc1-RHIRmdS9uhbEieZpSGQ6uvyYvopgpvzu8V-fX1y93N9-7257cfN9e3nZdcti6OTujBcBZGziIPGh24CCCMkaEPug_AtO_54LySykS5hdFxUJFHcFse5BX5cNLF89BNbXafqodpwuPnpVotxDgIpRB8_w94Py8FPVcrmOIDBmcQ2pwgj2ZrgWhzSXtXHi1ndi3GrsXYtRi7FoML786qy3YP4S9-bgIBcwIAQ3hIUGz1GJDHsAqGacOc_qf9B_WFnkI
startdate200009
enddate200009
creator
0Puolakka, Risto
1Haasio, Juhani
2Pitkänen, Mikko T
3Kallio, Markku
4Rosenberg, Per H
general
0Elsevier Inc
1BMJ Publishing Group LTD
scope
0CGR
1CUY
2CVF
3ECM
4EIF
5NPM
6AAYXX
7CITATION
83V.
97RV
107X7
117XB
1288E
1388I
148AF
158AO
168FI
178FJ
188FK
19ABUWG
20AZQEC
21BENPR
22DWQXO
23FYUFA
24GHDGH
25GNUQQ
26HCIFZ
27K9.
28KB0
29M0S
30M1P
31M2P
32NAPCQ
33PQEST
34PQQKQ
35PQUKI
36PRINS
37Q9U
38S0X
397X8
sort
creationdate200009
titleTechnical aspects and postoperative sequelae of spinal and epidural anesthesia: A prospective study of 3,230 orthopedic patients
authorPuolakka, Risto ; Haasio, Juhani ; Pitkänen, Mikko T ; Kallio, Markku ; Rosenberg, Per H
facets
frbrtype5
frbrgroupidcdi_FETCH-LOGICAL-c313t-f9a276810d910f1d7100afee2883d4d74de07c416ac5358f3be9a1e5f1feab1d3
rsrctypearticles
prefilterarticles
languageeng
creationdate2000
topic
0Adolescent
1Adult
2Aged
3Aged, 80 and over
4Anesthesia, Epidural - adverse effects
5Anesthesia, Spinal - adverse effects
6Female
7Humans
8Male
9Middle Aged
10Orthopedic Procedures
11Postoperative Complications - etiology
12Prospective Studies
toplevel
0peer_reviewed
1online_resources
creatorcontrib
0Puolakka, Risto
1Haasio, Juhani
2Pitkänen, Mikko T
3Kallio, Markku
4Rosenberg, Per H
collection
0Medline
1MEDLINE
2MEDLINE (Ovid)
3MEDLINE
4MEDLINE
5PubMed
6CrossRef
7ProQuest Central (Corporate)
8Nursing & Allied Health Database
9Health & Medical Collection
10ProQuest Central (purchase pre-March 2016)
11Medical Database (Alumni Edition)
12Science Database (Alumni Edition)
13STEM Database
14ProQuest Pharma Collection
15Hospital Premium Collection
16Hospital Premium Collection (Alumni Edition)
17ProQuest Central (Alumni) (purchase pre-March 2016)
18ProQuest Central (Alumni Edition)
19ProQuest Central Essentials
20ProQuest Central
21ProQuest Central Korea
22Health Research Premium Collection
23Health Research Premium Collection (Alumni)
24ProQuest Central Student
25SciTech Premium Collection
26ProQuest Health & Medical Complete (Alumni)
27Nursing & Allied Health Database (Alumni Edition)
28Health & Medical Collection (Alumni Edition)
29Medical Database
30Science Database
31Nursing & Allied Health Premium
32ProQuest One Academic Eastern Edition
33ProQuest One Academic
34ProQuest One Academic UKI Edition
35ProQuest Central China
36ProQuest Central Basic
37SIRS Editorial
38MEDLINE - Academic
jtitleRegional anesthesia and pain medicine
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Puolakka, Risto
1Haasio, Juhani
2Pitkänen, Mikko T
3Kallio, Markku
4Rosenberg, Per H
formatjournal
genrearticle
ristypeJOUR
atitleTechnical aspects and postoperative sequelae of spinal and epidural anesthesia: A prospective study of 3,230 orthopedic patients
jtitleRegional anesthesia and pain medicine
addtitleReg Anesth Pain Med
date2000-09
risdate2000
volume25
issue5
spage488
epage497
pages488-497
issn1098-7339
eissn1532-8651
abstractBackground and Objectives: Major complications after spinal or epidural anesthesia are extremely rare. The occurrence of less serious and transient sequelae and complaints may be underestimated if there is no established organization for the systematic and continuous surveillance of patients after anesthesia. This study was designed to evaluate the possible relationship between various block-related occurrences and the intra- and postoperative side effects and complaints. Methods: This prospective study included 3,230 orthopedic patients operated on under neuraxial block. The block was performed by single-dose (single-shot spinal anesthesia [SPIN], 80.6%), continuous spinal anesthesia (CSA, 10.3%), or combined spinal and epidural anesthesia (CSE, 9.1%) technique. The patient position during surgery and a detailed description of block performance and equipment, as well as all intraoperative problems, were immediately recorded. Every patient was given a standardized questionnaire to be completed and returned after 1 week. Results: The overall incidence of paresthesia was 12.8%, being most frequent during spinal catheter insertion with multiple attempts. Postoperative sensory disturbances (numbness, dysesthesia) occurred unrelated to paresthesia elicited by the puncture or catheterization. The failure rates (SPIN, 1.0%; CSA, 1.5%; and CSE, 1.0%) were quite low. Asystole with successful resuscitation, occurred in 1 patient with CSE but, overall, hemodynamic perturbations were more common with the continuous techniques. On the first postoperative day, decreased sensation of the skin was significantly more frequent after the continuous techniques, still present in 6.5% of SPIN patients, 6.1% of CSA patients, and 17.2% of CSE patients 1 week after surgery. These disturbances were also related to the use of a tourniquet and lateral position of the patient during surgery. The frequency of postdural puncture headache (PDPH) was similar for the different techniques (SPIN, 0.9%; CSA, 1.5%; and CSE, 1.7%). About one third of the patients reported strong postoperative pain on the day after the operation, and 5.6% continued to report this at 1 week. Conclusions: Although sensory changes were quite frequent, they were mild and transient. Rather than having been caused by the anesthetic technique, per se, a “nonanesthetic” reason (position, tourniquet, immobilization) should also be considered as their origin. Sensory disturbances, as well as strong pain for at least a week, were reported by several patients, and to become aware of these problems and improve the quality of treatment, a universal regional anesthesia follow-up system is recommended. Reg Anesth Pain Med 2000;25:488-497.
copEngland
pubElsevier Inc
pmid11009234
doi10.1053/rapm.2000.7607