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Anesthesia (19)
Author(s) -
Steinbrook Richard A.,
Concepcion Mercedes A.
Publication year - 2001
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2001.1011-19.x
Subject(s) - medicine , anesthesia , lidocaine , hemodynamics , heart rate , epinephrine , blood pressure , cardiac index , mean arterial pressure , respiratory rate , lumbar , cardiac output , surgery
Respiratory gas exchange and hemodynamics during lumbar epidural anesthesia: effects of lidocaine with and without epinephrine. (New England Medical Center, Tufts University School of Medicine, Boston, MA) Reg Anesth Pain Med 2000;25:380–384. In this study, 12 healthy patients (age, 22 to 46 years) undergoing surgery on the knee were randomly assigned to receive either 2% lidocaine (Group L) or 2% lidocaine with epinephrine 5 μg · mL −1 (Group E), approximately 20 mL, over 10 min via lumbar epidural catheter. Total‐body oxygen consumption (VO 2 ) and carbon dioxide production (VCO 2 ) were determined by indirect calorimetry; hemodynamic measurements were obtained by noninvasive thoracic electrical bioimpedance. Values of VO 2 , VCO 2 , heart rate (HR), cardiac index (CI), and mean arterial blood pressure (MAP) were determined every minute and averaged every 5 min for 30 min. Comparisons were made with analysis of variance (ANOVA) (within groups) and t ‐tests (between groups). Differences were considered significantly different if P < 0.05. VO 2 did not change in either group, while VCO 2 increased significantly by 22% at 20 min in Group E. Increases in HR were apparent in both groups, with significantly greater increases in Group E. CI did not change in Group L, but increased by 41% in Group E. MAP decreased significantly by 11% in Group E, but did not change in Group L. Conclude that the addition of epinephrine, 5 μg · mL −1 , to the epidural injection of 2% lidocaine is associated with changes not only in hemodynamics, but also in respiratory gas exchange.