PMID: 11915061Mar 27, 2002Paper

Distribution of solution in the epidural space: examination by cryomicrotome section

Regional Anesthesia and Pain Medicine
Q H Hogan

Abstract

The routes of distribution and barriers to flow of solutions in the epidural space are incompletely determined. This study examined macroscopic details of epidural injectate spread in postmortem humans by cryomicrotome imaging. Soon after death, 3 nonembalmed adult human subjects were injected with ink through epidural catheters inserted by standard techniques. Following freezing, microtome sectioning was performed to reveal anatomic features down to 100 microm. To control for effects of death, an adult baboon was injected during general anesthesia and subsequently examined in the same fashion. Injected ink was readily evident and showed spread as rivulets through numerous small channels rather than as a unified advancing front. The fascia that extends laterally from the posterior longitudinal ligament is an important barrier restricting solution flow. Solution preferentially traveled along the nerve root sheath through the intervertebral foramen. Distribution of solution in the epidural space is nonuniform. Rather than a uniform advancing front, spread is directed among paths between structures according to pressures by which they are compressed. No structural barriers block flow through the intervertebral foramina or spinal c...Continue Reading

Citations

Jan 8, 2019·F1000Research·Carlos DelgadoLaurent A Bollag
Dec 17, 2011·Anesthesiology Research and Practice·Maria BauerEhab Farag
Jun 21, 2020·The Anatomical Record : Advances in Integrative Anatomy and Evolutionary Biology·Hemmo A BosscherMiles R Day
Jan 18, 2017·Case Reports in Anesthesiology·Daryl I Smith, Ryan Anderson
Oct 25, 2011·Pain Practice : the Official Journal of World Institute of Pain·Saeed AnsariHemmo A Bosscher
Nov 8, 2020·Regional Anesthesia and Pain Medicine·Robert G EastherJose C A Carvalho
Mar 12, 2021·Current Pain and Headache Reports·Thomas VerbeekHenry Liu
Aug 20, 2021·Drug Metabolism and Disposition : the Biological Fate of Chemicals·Sara ShumNina Isoherranen

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