Sensory blockade of S3 dermatome prevents pain during bladder catheterization

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
F Asato, A Kanai

Abstract

We often encounter patients who do not complain of pain on undergoing invasive urogenital or rectal procedures, despite incomplete epidural blockade of sacral cutaneous sensation. To clarify whether or not urethral pain is blocked faster than sacral cutaneous sensation during lumbar epidural anesthesia, we investigated the correlation between occurrence of urethral pain and loss of cold sensation in the S1-3 dermatomes. In 46 gynecological patients, Group A (n=22) received 15 ml of 2% mepivacaine via an epidural catheter inserted cephaladly. Group B (n=24) received 5 ml of 2% mepivacaine directly in the epidural needle directed caudally and 10 ml of 2% mepivacaine via the epidural catheter inserted cephaladly. A Foley catheter was inserted into the urethra 30 min after the injection. Urethral pain, which was defined as a pained facial expression and/or complaint of pain, was observed in seven patients in Group A, and none in Group B. The caudad level of epidural blockade was significantly lower in patients without urethral pain (S3, median) than with urethral pain (L4) (P <0.05). In 39 patients without urethral pain, 19 (49%) experienced loss of cold sensation in the S1 dermatome, 27 (69%) in the S2 and 38 (97%) in the S3 25 mi...Continue Reading

References

Jan 1, 1977·Urologia Internationalis·H Kiesswetter
Apr 1, 1976·The Journal of Physiology·G L CliftonW D Willis
Jan 1, 1975·British Journal of Anaesthesia·A GalindoJ J Bonica
Oct 1, 1987·Pflügers Archiv : European journal of physiology·E BahnsW Jänig
Jan 1, 1974·Journal of Neurosurgery·G L RockswoldS N Chou
Aug 1, 1995·British Journal of Anaesthesia·S B McMahonM Koltzenburg
Oct 1, 1994·Anesthesia and Analgesia·D C Moore
Feb 20, 1998·Pain·Ursula WesselmannLeslie J Heinberg

❮ Previous
Next ❯

Citations

Sep 25, 2009·Der Urologe. Ausg. A·A Klotz, O Moormann
Jun 17, 2003·Neurourology and Urodynamics·Akiyuki HiragaTasuku Hashimoto

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bladder Carcinoma In Situ

Bladder Carcinoma In Situ is a superficial bladder cancer that occurs on the surface layer of the bladder. Discover the latest research on this precancerous condition in this feed.

Related Papers

The Clinical Journal of Pain
Winston DeMello, Parag R Desai
Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society
Ritin S Fernandez, Rhonda D Griffiths
Journal of Clinical Ultrasound : JCU
Kousei IshigamiYousef El-Zein
The Journal of Urology
Carl K Gjertson, Chandru P Sundaram
© 2021 Meta ULC. All rights reserved