Spinal cord protection during aortic occlusion: Efficacy of intrathecal tetracaine

Breckwoldt, William L.; Genco, Christopher M.; Connolly, Raymond J.; Cleveland, Richard J.; Diehl, James T.

doi:10.1016/0003-4975(91)91015-n

Cited by 36 publications

(12 citation statements)

References 19 publications

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“…In our experience, this is approximately 50% less time than previously necessary to perform the suture technique, which contributes to higher survival rates and faster recovery time. As reported by the literature, researchers often apply infrarenal aortic occlusion for 30-60 minutes to mimic spinal cord injury in rabbits and rats (23-25). Although this model of injury can also occur with thoracic aortic occlusion in mice (26), we found that infrarenal aortic occlusion longer than 30 minutes, resulted in an increasing hindlimb paralysis rates after the operation because of more spinal cord injury and longer ischemic times of hindlimbs when we performed abdominal heart transplantation or aortic interposition grafts using the conventional end to end suture technique.…”

Section: Discussionmentioning

confidence: 99%

A simplified cuff technique for abdominal aortic transplantation in mice

Zhu

Esckilsen

Atkinson

et al. 2016

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

A simplified cuff technique for abdominal aortic transplantation in mice

Zhu

Esckilsen

Atkinson

et al. 2016

Journal of Surgical Research

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“…71 Robertson et al 72 evaluated the protective effect of lidocaine followed by aortic occlusion in a rabbit model and did not find that lidocaine was effective for lowering the incidence of spinal cord injury. Conversely, Breckwoldt et al 73 reported that intrathecal tetracaine helped to prevent postischemic spinal cord injury in a rabbit model. However, the protective effect of tetracaine is probably related to the suppression of cellular metabolism and stabilization of the neuronal cell membrane.…”

Section: Administration Of Neuroprotective Agentsmentioning

confidence: 96%

Spinal Cord Protection During Thoracoabdominal Aneurysm Repair

Tabayashi

2005

Surg Today

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Spinal cord injury after thoracoabdominal aortic surgery remains a devastating and unpredictable complication, caused by clamping of the thoracoabdominal aorta, resulting in exclusion of blood flow in critical and essential intercostal arteries. Various protective methods against spinal cord ischemia have been proposed and performed clinically. These include preoperative spinal angiography, distal aortic perfusion, hypothermia, reattachment of the intercostal artery, cerebrospinal fluid drainage, administration of neuroprotective agents, and monitoring of somatosensory and motor-evoked potentials. The information to date suggests that multimodality approaches should be used to prevent spinal cord injury after thoracic and thoracoabdominal aneurysm repair.

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“…It promotes only a local spinal cord ischemia due to vascular stasis. Despite that fact, Breckwoldt et al 5 showed a similar effect with intrathecal tetracaine in a model of ischemic SCI by aortic clamping in rabbits. Under general anesthesia, rabbits underwent aortic clamping for 25 or 30 min after the intrathecal injection of tetracaine or saline.…”

Section: Objectif : Le Modèle Photochimique D'une Lésion Médullaire Rmentioning

confidence: 98%

“…These lesions may be seen in ischemic spinal cord models due to aortic clamping. 5,6 Various treatments have been proposed to prevent post-traumatic secondary lesions. Antagonists of opioid receptors (naloxone) 7,8 or gangliosides 9 appreciably improve neuronal function in animal models but have given inconstant and disappointing results in human clinical trials.…”

Section: Objectif : Le Modèle Photochimique D'une Lésion Médullaire Rmentioning

confidence: 99%

“…Intrathecal injection of local anesthetics (bupivacaine, tetracaine) appreciably reduces the functional consequences to the spinal cord of aortic clamping in rabbits. 5 Unfortunately, this encouraging report did not include studies of the structural and neurophysiological impact of the treatment on the spinal cord and on the secondary postischemic lesion. On the contrary, Wakamatsu et al 6 demonstrate that, in rabbits, moderate hypothermia (32°C), but not intrathecal tetracaine, significantly attenuated the increase in glutamate concentrations of intrathecal dialysate during spinal cord ischemia produced by occlusion of the abdominal aorta, and improved the neurologic and histopathologic outcome.…”

Section: Objectif : Le Modèle Photochimique D'une Lésion Médullaire Rmentioning

confidence: 99%

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Intrathecal bupivacaine protects against extension of lesions in an acute photochemical spinal cord injury model

Lopez¹,

Privat

Bernard³

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : The photochemical spinal-cord injury model reproduces extensive secondary lesions that occur after spinal injury. We have evaluated in 27 rats the functional, electrophysiological and anatomical consequences of a photochemical spinal-cord lesion induced before or after intrathecal injection of bupivacaine.M Me et th ho od ds s: : After randomization, nine rats received 20 µL of intrathecal bupivacaine 0.5% 15 min before a photochemical spinal-cord lesion (Group I) and eight rats received 20 µL intrathecal bupivacaine 15 min after such a lesion (Group II). Ten rats received 20 µL of saline 15 min before the photochemical injury (control group).Paraplegia was tested on days one, three, five, seven, nine, 12, 15 and 18 using an evaluation of hindlimb movements and an inclined plane stability test. Sensory block was evaluated by the animal's response when each hindlimb was brought into contact with a hot plate. Sympathetic injury was evaluated in terms of bladder voiding dysfunction. On day 18, residual somatosensory evoked potentials (SEP) were measured and the area of the intact spinal cord was determined using a digitalized system. R Re es su ul lt ts s: : Early paraplegia recovery was found in the two bupivacaine groups (P < 0.05). On day 12, motor recovery was complete in both bupivacaine groups whereas recovery was not complete on day 18 in the control group. Compared to the control group, inclined plane stability recovered earlier in Groups I and II, from day three to day 15. Sensory and sympathetic block scores were not different in the three groups. Nevertheless, SEP latencies were longer and amplitudes were lower in control group rats compared with the two bupivacaine groups on day 18. The intact spinal-cord cross-sectional area around the lesion was not different in the three groups.C Co on nc cl lu us si io on n: : Twenty microlitres of intrathecal bupivacaine before or after acute photochemical spinal injury improves hindlimb motor recovery and SEP parameters in rats. Objectif

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Spinal cord protection during aortic occlusion: Efficacy of intrathecal tetracaine

Cited by 36 publications

References 19 publications

A simplified cuff technique for abdominal aortic transplantation in mice

A simplified cuff technique for abdominal aortic transplantation in mice

Spinal Cord Protection During Thoracoabdominal Aneurysm Repair

Intrathecal bupivacaine protects against extension of lesions in an acute photochemical spinal cord injury model

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