CT-guided puncture of the cervical subarachnoid space.
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Seventeen patients with luetic uveitis had human immunodeficiency virus (HIV) testing and lumbar puncture to determine if the HIV-positive status altered the clinical profile of syphilis. Twelve of the 17 patients tested positive for HIV. All 12 patients had abnormal lumbar punctures, but only two of the five HIV-negative patients had abnormal results of spinal taps. Ocular disease also was more severe in the HIV-positive group.
PURPOSE: This study was performed to determine spinal cord blood flow using the H2 clearance method. METHODS: In 12 dogs we measured blood flow determined by hydrogen clearance techniques (BF) in both gray and white matter by spinal cord puncture, and compared the results with BF measured by a catheter inserted intrathecally to avoid spinal cord injury. We studied direct intraarterial and intravenous injection of hydrogen in addition to the inhalation method because hydrogen is an explosive gas. RESULTS: BF measured intrathecally with catheters adherent to either the ventral or the dorsal funiculus did not differ significantly from that of the gray matter. BF measured with a catheter inserted into the epidural space was about one fourth of the BF measured intrathecally. Values measured by the intraarterial injection method did not differ significantly from those obtained by the inhalation method. CONCLUSIONS: BF measured with a catheter inserted intrathecally reflects blood flow in the gray matter of the spinal cord. Using intraarterial injection of H2, BF was safety and accurately measured while avoiding the risk of explosion.
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The effect of employing different interspaces for lumbar puncture during spinal anaesthesia was evaluated in 40 patients receiving 4 ml of 0.5% plain bupivacaine at level L2/L3 or L4/L5. No differences were observed in onset, spread or duration of analgesia. Furthermore, we found that only 80% of the patients, independently of the interspace used, had a cephalad spread to T8 and conclude that spinal anaesthesia using plain bupivacaine is not ideal for supraumbilical surgery.
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