Effect of Intrathecal Epinephrine on Rabbit Spinal Cord

Ml, Berman; Wj, Murray

doi:10.1213/00000539-197205000-00015

Cited by 4 publications

(2 citation statements)

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“…Single intrathecal injection of plain epinephrine (up to 0.5 mg) is not associated with histologic injury in rabbits 13,14 or rats. 15,16 Similarly benign results are reported after repeated 16 or continuous injection, except at exceedingly high (10 times normal) doses in monkeys.…”

Section: Histopathologic and Behavioral Effectsmentioning

confidence: 92%

“…13 Rats exposed to high concentrations of intrathecal lidocaine and epinephrine demonstrated persistent sensory impairment that was worse than observed with lidocaine alone. 15 In humans, 50 g epinephrine added to intrathecal 10 mg lidocaine plus 10 g sufentanil did not grossly affect spinothalamic, dorsal column, or motor function.…”

Section: Histopathologic and Behavioral Effectsmentioning

confidence: 98%

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Effects of epinephrine in local anesthetics on the central and peripheral nervous systems: Neurotoxicity and neural blood flow

Neal

2003

Regional Anesthesia and Pain Medicine

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Section: Histopathologic and Behavioral Effectsmentioning

confidence: 92%

Section: Histopathologic and Behavioral Effectsmentioning

confidence: 98%

Effects of epinephrine in local anesthetics on the central and peripheral nervous systems: Neurotoxicity and neural blood flow

Neal

2003

Regional Anesthesia and Pain Medicine

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The Neurotoxicity of Drugs Given Intrathecally (Spinal)

Hodgson¹,

Neal²,

Pollock³

et al. 1999

Obstetric Anesthesia Digest

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Association between perioperative neuraxial local anesthetic neurotoxicity and arachnoiditis: a narrative review of published reports

Brenna,

Khan,

Poots

et al. 2023

Reg Anesth Pain Med

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Background/importanceArachnoiditis is a rare but devastating disorder caused by various insults, one of which is purported to be local anesthetic neurotoxicity following neuraxial blockade. However, the relationship between local anesthetics administered into the neuraxis and the development of arachnoiditis has not been clearly elucidated.ObjectiveWe aimed to summarize the existing complex body of literature and characterize both the essential features and strength of any association between neuraxial local anesthetic neurotoxicity and arachnoiditis with a view toward mitigating risk, enhancing prevention, and refining informed consent discussions.Evidence reviewWe reviewed all published reports of arachnoiditis attributed to local anesthetic neurotoxicity following perioperative neuraxial anesthesia. This narrative review was based on a systematic search methodology, which included articles published up until December 2022.FindingsThirty-eight articles were included, comprising 130 patients, over one-half of which were published prior to this century and inconsistent with modern practice. Neuraxial techniques included 78 epidurals, 48 spinals, and 5 combined spinal-epidurals, mostly for obstetrics. Reporting of essential procedural data was generally incomplete. Overall, at least 57% of patients experienced complicated needle/catheter insertion, including paresthesia, pain, or multiple attempts, irrespective of technique. The onset of neurological symptoms ranged from immediate to 8 years after neuraxial blockade, while the pathophysiology of arachnoiditis, if described, was heterogeneous.ConclusionsThe existing literature attributing arachnoiditis to local anesthetic neurotoxicity is largely outdated, incomplete, and/or confounded by other potential causes, and thus insufficient to characterize the features and strength of any association.

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Effect of Intrathecal Epinephrine on Rabbit Spinal Cord

Cited by 4 publications

References 0 publications

Effects of epinephrine in local anesthetics on the central and peripheral nervous systems: Neurotoxicity and neural blood flow

Effects of epinephrine in local anesthetics on the central and peripheral nervous systems: Neurotoxicity and neural blood flow

The Neurotoxicity of Drugs Given Intrathecally (Spinal)

Association between perioperative neuraxial local anesthetic neurotoxicity and arachnoiditis: a narrative review of published reports

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