Local anesthetics, such as lidocaine or levobupivacaine, which we use in our procedures, have their own antibacterial effects [1], and their antibacterial effects have already been identified in previous studies [2]. All of our procedures can cause various complications, such as infection, bleeding, dura puncture, and post intervention pain. Though there is no report on overall incidence of infection, which is one of the complications, it is reported that the incidence rate of in-fectious spondylodiscitis after spine surgery is 0.05-5.3% [3].And in very rare cases, there has been a psoas abscess after injection at the pain trigger point of the spinal muscle [4].Based on these findings, although infection is not common, it is an important complication to be avoided because of the variety of sites and features. Causes of infection include air contamination, carelessness of the operator, blood circulation of the primary infection, and the most common cause during the procedure is contamination of the needle entry path due to patient skin contamination. Though local anesthetics we
Background Pacing-induced atrial electrical remodeling AER is characterized by shortening of atrial effective refractory period A-ERP and its altered rate adaptation. In paroxysmal atrial fibrillation AF , periods of AF occur with interveneing normal sinus rhythm NSR when atria recover from the preceding AER. Previous episodes of AF may precondition the atrial myocardium and cause different time course of AER in subsequent episodes of AF. But the influence of the preceding AER on the subsequent AER has not been described. Methods Four mongrel dogs were anesthetized with enflurane. After thoracotomy, silicon band with 3 pairs of electrodes was sutured to the lateral wall of the left atrium. Atrial pacing was performed after 2 wks of recovery and autonomic blockade. Pacing protocol consisted of rapid atrial pacing RAP at 500 bpm for 60 min and recovery in NSR for 60 min which was repeated three times. A-ERP was measured every 10 min. The same pacing protocol was repeated after pretreatment with verapamil 0.1 mg/kg/hr). Results 1 With 60 min of RAP, A-ERP decreased significantly 126 6 ms vs. 105 7 ms, p 0.005 . 2 After cessation of pacing, A-ERP returned to 98% of baseline value in 15 minutes. Recovery from AER occurred faster than AER 78 vs 21 ms/h . 3 After pretreatment with verapamil, RAP decreased A-ERP from 127 5 ms to 116 5 ms. AER, the reduction in A-ERP, was significantly attenuated by pretreatment with verapamil ERP 17 7 vs. 9 0.2 %, p 0.05 . 4 When RAPs were repeated, AER showed a tendency of acceleration, but it was not statistically significant ERP 22 ms, 24 ms, 28 ms at the end of 60 min pacing for the 1
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