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Perineural injection to nerve root and radicular blood flow: a clinical study during spinal surgery

Published online by Cambridge University Press:  16 August 2006

M. Fukusaki
Affiliation:
Department of Anaesthesia, Nagasaki Rosai Hospital, 2-12-5, Setogoshi, Sasebo
M. Miyako
Affiliation:
Department of Anaesthesia, Nagasaki Rosai Hospital, 2-12-5, Setogoshi, Sasebo
T. Nakamura
Affiliation:
Department of Anaesthesia, Nagasaki Rosai Hospital, 2-12-5, Setogoshi, Sasebo
H. Miyoshi
Affiliation:
Department of Anaesthesia, Nagasaki Rosai Hospital, 2-12-5, Setogoshi, Sasebo
K. Sumikawa
Affiliation:
Department of Anaesthesiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto
H. Konishi
Affiliation:
Department of Orthopaedics, Nagasaki Rosai Hospital, 2-12-5 Setogoshi, Sasebo, Nagasaki, Japan
S. Hara
Affiliation:
Department of Orthopaedics, Nagasaki Rosai Hospital, 2-12-5 Setogoshi, Sasebo, Nagasaki, Japan
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Abstract

Background and objective To investigate the effects of the perineural injection of lidocaine or corticosteroids on radicular blood flow during spinal surgery.

Methods After lumbar discectomy, a probe for laser Doppler flowmetry was placed directly on the 4th or 5th lumbar nerve root. Thirty patients undergoing lumbar discectomy were randomly assigned to one of three groups. Each group received one of three protocols for a perineural injection to the nerve root: 1.0 mL 0.9% saline in group A, 1.0 mL 1% lidocaine in group B or 1.0 mL dexamethasone (4 mg) in group C. Measurements included radicular blood flow, mean arterial pressure, haemoglobin concentration, percutaneous oxygen saturation and end-tidal carbon dioxide tension. Radicular blood flow was measured by laser Doppler flowmetry before the injection and 15 min after these injections. The three groups were similar with respect to mean arterial pressure, haemoglobin concentration, percutaneous oxygen saturation and end-tidal carbon dioxide tension.

Results Radicular blood flow did not change after the injection in any of the groups.

Conclusions The results suggest that the perineural injection of 1% lidocaine or dexamethasone does not affect radicular blood flow during lumbar discectomy.

Type
Original Article
Copyright
2001 European Society of Anaesthesiology

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