Sir,—A 10-yr-old girl with scoliosis underwent corrective surgery during general anaesthesia combined with a continuous thoracic extradural. During surgery she received extradural fentanyl 4 g ml 1 which was continued after operation. Anaesthesia and surgery were uneventful. After operation the extradural infusion was set at 2–6 ml h 1 and she had satisfactory pain control. On the third day aft...

Meningiomas are common spinal tumor and mostly located at intradura. Recurrence rate after surgery for extradural meningioma was higher than intradural meningioma. A patient with intra and extradural spinal meningioma was treated and discussed its features and clinical management. A 41-year-old woman noted numbness of bilateral legs, gait disturbance, and mild bladder disturbance for over the t...

We studied prospectively 1381 patients undergoing extradural anaesthesia for total hip or total knee replacement, to determine if extradural anaesthesia can be performed reliably in patients who have had previous lumbar spine surgery. Fifty-two of the 57 patients (91.2%) who had undergone lumbar spine surgery received a successful extradural anaesthetic, and 1307 of 1324 patients without previo...

We have compared the efficacy and side effects of extradural morphine with extradural fentanyl for postoperative pain relief. Thirty children (ages 1-16 yr) were allocated randomly to receive, after extradural administration of 0.5% bupivacaine 0.75 ml kg-1 and before surgical incision, extradural morphine 0.75 microgram kg-1 (group M), with an additional dose administered 24 h later or extradu...

We report three previously healthy individuals, aged 19-40 yr, with co-existing infected lower limb cutaneous wounds, who developed, in all probability, spinal space infections complicating continuous extradural analgesia. As the number of patients with extradural catheters and large cutaneous wounds represents a small fraction of the total number of patients with extradural catheters, three ca...

Two resin injection studies of the lumbar extradural space were performed to elucidate its size and shape. To counteract the lack of cerebrospinal fluid pressure in the cadaver, the subarachnoid space was filled with water. In group 1, the extradural injection of resin caused an immediate increase in subarachnoid pressure. The casts produced varied in thickness, but were situated predominantly ...

Thirty patients took part in a double-blind trial to compare morphine 10 mg i.m. with morphine 5 mg into the extradural space for pain relief following Caesarean section. With the extradural route the mean time to first analgesia was 7.95 h compared with 4.75 h for the i.m. route. The mean number of further doses of diamorphine 7.5 mg required for pain relief in the first 24 h was 1.93 (+/- 0.3...

Bilateral extradural hematomas are rare and follow significant trauma. The mortality is higher than with unilateral single extradural hematomas and postoperative outcome depends on preoperative neurological status.

Extradural spinal meningiomas are rare. Our understanding of purely extradural spinal meningiomas is still incomplete and they may be easily confused with malignant neoplasms, much more common in this location. We report a rare case of a purely extradural thoracic spine meningioma in a 70-year-old man, with an unusual progression. In addition we discuss the pathogenesis of these tumors and the ...

We have examined postoperative pain in patients allocated randomly to receive extradural bolus diamorphine 3.6 mg, extradural infusion of 0.15% bupivacaine with 0.01% diamorphine or patient-controlled i.v. administration of diamorphine at a maximum rate of 1 mg per 5 min, after total abdominal hysterectomy. Extradural infusion analgesia produced the smallest pain scores from 12 to 24 h after su...