Regulation of Proprioceptive Memory by Subarachnoid Regional Anesthesia

  title={Regulation of Proprioceptive Memory by Subarachnoid Regional Anesthesia},
  author={Sheldon A. Isaacson and Matthew Funderburk and Jay Wen-Je Yang},
Background Patient perception of limb position during regional anesthesia is frequently incorrect. The existing model ascribes this misperception, or phantom sensation, as a reversion to a fixed, slightly flexed, body schema. A model was developed to evaluate the influence of limb position changes on the incidence of incorrect or phantom sensations during regional anesthesia. Methods Forty American Society of Anesthesiologists physical status I—III adult patients undergoing genitourinary… 

Memory by subarachnoid regional anesthesia.

In their statistically elegant study of lower limb phantom posture during induction of spinal anesthesia, Dr. Isaacson et al. have reverted to a plastic model determined by limb posture during the onset of anesthetic blockade that was unlikely to guarantee reliable phantom development within the restricted 10-min period of their observations.

Influence of Sensory and Proprioceptive Impairment on the Development of Phantom Limb Syndrome during Regional Anesthesia

A better understanding of the determinants of PLS is provided by showing that the final position of P LS is related both to the abolition of proprioception and the initial position of the anesthetized limb.

Intubating laryngeal mask airway and muscle relaxants: never together?

In their statistically elegant study of lower limb phantom posture during induction of spinal anesthesia, Dr. Isaacson et al. have reverted to a plastic model determined by limb posture during the onset of anesthetic blockade that was unlikely to guarantee reliable phantom development within the restricted 10-min period of their observations.

Temporal analysis of regional anaesthesia-induced sensorimotor dysfunction: a model for understanding phantom limb.

The results suggest the involvement of an alteration of proprioception and motor functions in the origin of this phenomenon, and agree with the motor awareness theory.

Phantom limb syndrome induced by combined spinal and epidural anesthesia in patients undergoing elective open gynecological surgery

This study is the first to have identified the risk factors for PLS, assessed the relationship between PLS and postoperative sensorimotor impairment, and its influence on postoperative complications.

The phenomenology of body image distortions induced by regional anaesthesia.

It was found that perceptual changes concerning the shape and size of the deafferented limb occurred in the great majority of patients, and these observations show that the perception of body shape and the awareness of its postural variations are built from different plastic models.

Proprioception in osteoarthritis

In a population of healthy elderly participants, there was no association of JMS with JPS (either AJPS or PJPS) and the association of AJPS with PJPS was weak, suggesting that JMS and JPS are representing different aspects of joint proprioception.

Dynamic changes in the perceived posture of the hand during ischaemic anaesthesia of the arm

Surprisingly, if the wrist and fingers are held straight during anaesthesia, the perceived phantom hand becomes bent at the wristand fingers, but if they are bent during anaesthetic, the final phantom is extended at the wrists and fingers.

Residual Limb Pain Is Not a Diagnosis: A Proposed Algorithm to Classify Postamputation Pain

The historical evolution of the current understanding of these syndromes are reviewed, an algorithm for uniform classification is proposed, and reported variation in the incidence of PAP phenomena may well represent inconsistency in assessment tools and diagnostic categories rather than variation in prevalence.



Phantom Sensations During Spinal Anesthesia

One hundred patients for elective surgical procedures were given tetracaine spinal anesthesia and observations were made in regard to time of injection, onset of motor blockade and limb position

Phantom limbs and the body schema.

The results lead us to agree with Holmes and Head's proposition that conduction blockade remains the most useful method currently available for reversible deafferentation in man, and for the evocation of phantom phenomena.

Proprioceptive, visual and vestibular thresholds for the perception of sway during standing in humans.

Thresholds for the perception of postural sway induced by gentle perturbations were determined for five normal standing subjects and both the proprioceptive and visual thresholds were sufficiently small to allow perception of the sway that was recorded when the subjects stood normally in a relaxed manner.

Long-term potentiation in an isolated peripheral nerve-spinal cord preparation.

The capacity of the isolated neonatal rat spinal cord to sustain a long-lasting increase in a nociceptive-related slow ventral root potential (sVRP) recorded from a lumbar root after a tetanic train of stimuli to the peripheral cutaneous saphenous nerve is investigated.

The phantom phenomenon: a critical review

  • G. RibbersT. MulderR. Rijken
  • Psychology, Medicine
    International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation
  • 1989
There is an outstanding need for a general theory to synthesise the knowledge gained to date about the multiplicity of factors associated with phantom phenomena, and Melzack and Loeser's (1978) concept of "pattern generating mechanisms" may offer the most useful model for future research.

Blockade of Na+ and K+ Currents by Local Anesthetics in the Dorsal Horn Neurons of the Spinal Cord

In clinically relevant concentrations, local anesthetics block Na sup + and KA currents but not delayed‐rectifier K sup + currents in spinal dorsal horn neurons.

The effects of direction and acceleration of movement of the knee joint of the dog on medial articular nerve discharge.

The results indicate that the discharge activity of the whole medial articular nerve is influenced not only by joint position but also by the velocity and acceleration of movement.

Survival and function of auto- and homografts of adenohypophysial tissue in the toad, bufo bufo L.

The observations support the assumption that in amphibians the functional significance of the hypophysio-portal system is the same as in mammals, and the importance of immunological reactions for the function of homografts of this endocrine gland is discussed.

Complex blockade of TTX-resistant Na+ currents by lidocaine and bupivacaine reduce firing frequency in DRG neurons.

It is suggested that the frequency reduction at low local anesthetic concentrations may explain the phenomenon of paresthesia where sensory information are suppressed gradually during spinal anesthesia.