Stimulating Cervical Epidural Catheter
Bibliographic record
Abstract
To the Editor: Following up on the report by Tamai et al. (1), we wish to report an alternative technique of epidural catheter placement using electrical stimulation in a patient who underwent a left scapulectomy. The scapula receives sensory innervation from the C5-8 nerve roots (2), thus making cervical epidural an attractive option for postoperative analgesia. We identified the epidural space at T1-2 after 2 previous attempts at the C7-T1 level were unsuccessful. As our institution does not have catheters with stainless steel coils or stylets as recommended by Tamai et al. (1), we used the Arrow StimuCath Continuous Nerve Block Procedure Kit (Arrow International, Reading, PA). We ensured cephalic migration of the catheter from the thoracic approach into the cervical region by advancing the catheter until the upper extremity motor response (shoulder abduction) was elicited at an output of 3.1 mA (pulse width = 0.3 ms), as recommended by Tsui et al. (3). Satisfactory postoperative anesthesia was achieved with this technique. The Arrow StimuCath may be an option for epidural catheter placement under electrical stimulation guidance, but this should be properly investigated before it is widely adopted. Sher Yi Chan, MBBS, Mmed Juan Carlos De La Cuadra Fontaine, MD Julian Doan, MD De QH Tran, MD, FRCPC Department of Anesthesiology McGill University Health Center Montreal, Quebec, Canada [email protected]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.013 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.012 | 0.013 |
| Insufficient payload (model declined to judge) | 0.005 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".