We tested the hypothesis that cooling the extradural space may provoke shivering, by giving three 80-ml extradural injections of warm (39.8 +/- 1.2 degrees C) or cold (17 +/- 2.2 degrees C) saline to four healthy volunteers, whilst recording central temperature and electromyographic activity from four muscles. The first injection (always cold) did not induce shivering in any of the subjects. Th...

Intracranial extradural collection may cause an increase in intracranial pressure, requiring rapid emergency treatment to reduce morbidity and mortality. We described an alternative CT-guided percutaneous access for extradural collection drainage. We report a case of a patient with previous craniectomy for meningioma ressection who presented to the Emergency Department with symptoms of intracra...

We have compared the antinociceptive effect of extradural lignocaine on somatic and visceral nociception in pregnant (n = 11) and non-pregnant rats (n = 9). Colorectal distension (CD) threshold and tail flick (TF) latency were measured as visceral and somatic nociception, respectively, for 60 min after extradural injection. On days 19, 20 and 21 of pregnancy, rats received lignocaine 200, 400 o...

A multivariate analysis of inadequate extradural analgesia was carried out prospectively on 1051 patients undergoing lumbar extradural anaesthesia for surgery performed on structures innervated by T10-S5. Ninety-six patients (9%) experienced pain during surgery. Age, extradural fentanyl, diazepam sedation and duration of surgery had no significant influence. We found some weak evidence that the...

We have studied the effect of continuous extradural analgesia with bupivacaine and morphine, initiated before or after colonic surgery, in a double-blind, randomized study. Thirty-two patients were allocated randomly to receive an identical extradural block initiated 40 min before surgical incision (n = 16) or at closure of the surgical wound (n = 16). The extradural regimen consisted of a bolu...

Clonidine, an alpha2 adrenoceptor agonist, has anti-hypertensive and anti-nociceptive effects. It is commonly used in association with local anaesthetics and opioids to enhance the quality and duration of extradural analgesia in the postoperative period, and to decrease the incidence of side effects. As a sole analgesic, it has seldom been used to relieve postoperative pain. The dose of extradu...

A case is described of extradural abscess following extradural injection of local anaesthetic and steroid for the management of chronic low back pain. The common signs and symptoms are reviewed, possible causes discussed and the association with diabetes stressed.

We describe a patient who received an apparently uneventful extradural block in labour but developed rapid extension of neural block within minutes of receiving her first incremental dose 2 h later. Computed contrast tomography revealed radio-opaque dye within both the subdural and subarachnoid spaces, but none within the extradural space. This case report demonstrates that subdural spread of l...

Continuous extradural analgesia by means of repeated doses of local analgesic drugs through a catheter placed in the extradural space is now widely used in this country, both for the production of surgical analgesia and for the relief of pain. Using the caudal route, labour can be conducted painlessly, and by simply increasing the dosage the analgesia can be extended to cover a Caesarean sectio...