HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Svensson, L. G. Articles by Hinder, R. A. Search for Related Content PubMed PubMed Citation Articles by Svensson, L. G. Articles by Hinder, R. A.

The Journal of Thoracic and Cardiovascular Surgery, Vol 96, 823-829, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Intrathecal papaverine for the prevention of paraplegia after operation on the thoracic or thoracoabdominal aorta

LG Svensson, RW Stewart, DM Cosgrove 3d, BW Lytle, MD Antunes, EG Beven, AJ Furlan, A Gottlieb, DF Grum and RA Hinder
Department of Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio.

Eleven patients undergoing operation on the descending or thoracoabdominal aorta were administered papaverine intrathecally in an attempt to protect the spinal cord from ischemic damage. Concurrently, 19 patients, also undergoing operation on the thoracic or thoracoabdominal aorta, were operated on with a variety of conventional techniques, including distal aortic perfusion, but were not given intrathecal papaverine. No signs of early neurologic injury developed in any of the patients in the intrathecal papaverine group, although delayed paraparesis developed in one of the patients (9%; 70% confidence limits = 1% to 28%). On the other hand, eight of 19 patients undergoing operation with conventional techniques had either lower extremity paraparesis or paraplegia postoperatively (42%; 70% confidence limits = 29% to 57%; p = 0.058). Intrathecal papaverine appeared to provide spinal cord protection during thoracic aortic operations, particularly during prolonged periods of aortic cross- clamping. Papaverine was not associated with increased risk and may be superior to other conventionally used modalities. We conclude that continued evaluation of this technique is justified.

This article has been cited by other articles:

				R. A. Kahn, M. E. Stone, and D. M. Moskowitz Anesthetic Consideration for Descending Thoracic Aortic Aneurysm Repair Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2007; 11(3): 205 - 223. [Abstract] [PDF]

				B. Makkad and S. Pilling Management of Thoracic Aneurysm Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2005; 9(3): 227 - 240. [Abstract] [PDF]

				F. M. Follis, K. S. Blisard, P. S. Varvitsiotis, S. B. Pett Jr, R. T. Temes, and J. A. Wernly Selective protection of gray and white matter during spinal cord ischemic injury Ann. Thorac. Surg., May 1, 1999; 67(5): 1362 - 1369. [Abstract] [Full Text] [PDF]

				M. J. Murray, M. L. De Ruyter, N. E. Torres, J. J. Lunn, and B. A. Harrison Thoracoabdominal Aortic Aneurysm Repair: Reducing the Incidence of Paraplegia Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1999; 3(1): 30 - 33. [Abstract] [PDF]

				H. J. Safi, A. Winnerkvist, C. C. Miller III, D. C. Iliopoulos, M. J. Reardon, R. Espada, and J. C. Baldwin Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair Ann. Thorac. Surg., October 1, 1998; 66(4): 1204 - 1208. [Abstract] [Full Text] [PDF]

				L. G. Svensson, K. R. Hess, R. S. D'Agostino, M. H. Entrup, K. Hreib, W. A. Kimmel, E. Nadolny, and D. M. Shahian Reduction of neurologic injury after high-risk thoracoabdominal aortic operation Ann. Thorac. Surg., July 1, 1998; 66(1): 132 - 138. [Abstract] [Full Text] [PDF]

				M. C. Mauney, L. H. Blackbourne, S. E. Langenburg, S. A. Buchanan, I. L. Kron, and C. G. Tribble Prevention of Spinal Cord Injury After Repair of the Thoracic or Thoracoabdominal Aorta Ann. Thorac. Surg., January 1, 1995; 59(1): 245 - 252. [Abstract] [Full Text]

				J. A. Herold, I. L. Kron, S. E. Langenburg, L. H. Blackbourne, and C. G. Tribble Complete prevention of postischemic spinal cord injury by means of regional infusion with hypothermic saline and adenosine J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 536 - 542. [Abstract] [Full Text]