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Anesth Analg 1977; 56:352-355
© 1977 International Anesthesia Research Society
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Sympathetic Recovery Following Lumbar Epidural and Spinal Analgesia

JONG MIN KIM, MD*, ANTHONY D. LaSALLE, DDS{dagger}, and RAY T. PARMLEY, MD{ddagger}

*Assistant Professor, Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas 66103. {dagger}Assistant Professor, Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas 66103. {ddagger}Professor, Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas 66103.

Abstract

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 demonstrated by the decreasing amplitude of a digital pulse-wave (photoelectric plethys-mographic) 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 photoelectric plethysmography 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.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1977 by the International Anesthesia Research Society.