Observations on the Epidural Space

Macintosh, R. R.; William, W.

doi:10.1111/j.1365-2044.1947.tb02080.x

Cited by 46 publications

(15 citation statements)

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“…The Macintosh balloon could be made to re-inflate partially by increasing the pressure in the Paul's tubing and, similarly, the hanging drop could be made to oscillate with fluctuations of the pressure of the Paul's tubing. These findings agree with those of Macintosh (1950), but they do not confirm his belief that the pressure in the extradural space is dependent upon the pressure in the thoracic cavity. It is more probable that the changes he noted with ventilation were related to changes in the CSF pressure secondary to ventilation.…”

Section: Discussioncontrasting

confidence: 76%

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A Model of the Extradural Space and a Reappraisal of the Extradural Space Pressure

Harrison

1987

British Journal of Anaesthesia

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A model is described which was used to study the genesis of the pressure in the extradural space. It consists of a Perspex outer tube, with perforations covered with rubber septa to allow the insertion of needles, and Paul's tubing on the inside, representing the dura mater. The Paul's tubing is filled with water through a constant head of pressure apparatus. The response of the model to the insertion of an extradural needle and the reproduction of various clinical phenomena are described. The pressure in the extradural space is discussed in relation to the performance of the model.

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Section: Discussioncontrasting

confidence: 76%

“…(3) The negative pressure is the result of transmission of the negative intrathoracic pressure through the intervertebral foramina into the extradural space (Zorraquin, 1936;Macintosh and Mushin, 1947;Macintosh, 1950).…”

mentioning

confidence: 99%

A Model of the Extradural Space and a Reappraisal of the Extradural Space Pressure

Harrison

1987

British Journal of Anaesthesia

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“…In addition, the contralateral sensory block with the associated bilateral Horner's syndrome could be explained by paravertebral spread via either the prevertebral fascia 13,14 or the epidural route. 15 Unfortunately, the removal of the catheter precluded any imaging studies that might have led to a definitive etiology. Another patient factor to consider as a risk for contralateral spread should include cervical disk disease, specifically patients who have undergone cervical spine interventions that could lead to disruption of midline tissue.…”

Section: Discussionmentioning

confidence: 99%

Contralateral local anesthetic spread from an outpatient interscalene catheter

Dooley

Fingerman

Melton

et al. 2010

Can J Anesth/J Can Anesth

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Ambulatory continuous infusions are typically associated with few serious complications and a favourable safety profile. This case demonstrates that unexpected complications can still occur even after days of normal operation. Based on our previous experience, we believe this to be a rare but potentially serious event that requires awareness by those discharging patients with continuous infusions of local anesthetics.

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“…Thus any cause of pneumomediastinum may also result in pneumorrhachis [4,8] as in asthma, a complication of intubation or ventilation, retching or coughing and even vigorous exercise [9] Pathogenesis of Pneumorrhachis Macintosh and Mushin [12] demonstrated that the epidural space is not a closed cavity but is continuous with the paravertebral space via the intervertebral foramina. On inspiration the thoracic walls expand and the resultant negative pressure within the cage is transmitted via the paravertebral space to the epidural space.…”

Section: Discussionmentioning

confidence: 99%