Open AccessSympathetic Recovery Following Lumbar Epidural and Spinal Analgesia
Author(s) -
Jong Min Kim,
Anthony D. LaSALLE,
Ray T. Parmley
Publication year - 1977
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/00000539-197705000-00007
Subject(s) - medicine , anesthesia , spinal cord , lumbar , plethysmograph , surgery , psychiatry
During recovery from spinal and epidural block, the progressive reduction of digital blood flow is regarded as evidence of sympathetic recovery of the extremity. This was demostrated by the decreasing amplitude of a digital pulse-wave (photoelectric plethysmographic) recording. As the level of analgesia regressed to T8-11 following spinal or epidural block, the toe pulse-wave amplitudes began to decrease. In the presence of good motor and sensory block in the lower extremity with low spinal or epidural anesthesia (level of analgesia T-11 or below), the clinical or photoeletric plethysmographic evidence of sympathetic denervation was minimal or absent. According to these findings, the authors postulate that some preganglionic sympathetic fibers which conduct sympathetic stimulation to the lower extremity originate at spinal cord segments T-10 or above.