Korean J Anesthesiol.  1998 Jan;34(1):67-71. 10.4097/kjae.1998.34.1.67.

The Effect of Hemodynamic Changes on the Regression of Sensory Analgesia after Epidural Block

• Woo SC

• KMID: 2032344
• DOI: http://doi.org/10.4097/kjae.1998.34.1.67

Abstract

BACKGROUND
The aim of this study was to compare the difference in regression of sensory analgesia on hemodynamic changes between bupivacaine and lidocaine in epidural blockade.
METHODS
The thirty-six patients (ASA physical status Ior II) scheduled for elective cesarean section, we performed lumbar epidural blockade using 2% lidocaine (group I, II) or 0.5% bupivacaine (group III, IV). Eighty minutes after surgery, we divided the patients into 4 groups: The group I, III received normal saline, 20 ml, for 30 min; the group II, IV received normal saline, 20 ml, containing ephedrine, 2 mg ml, for 30 min. We compared the regression of sensory analgesia at 80 min with that at 140 min.
RESULTS
The proximal extent of sensory analgesia at 140 min was significantly lower than that at 80 min in group II. However, no such significant changes occurred in group I, III, IV.
CONCLUSIONS
The ephedrine-induced blood pressure increase accelerates regression of epidural blockade using lidocaine. We thought that even moderate and clinically insignificant cardiovascular activation by anxiety or pain can be a cause of reduction in the efficacy and duration of epidural blockade.

Keyword

Anesthetic techniques: epidural; Anesthetics, local: bupivacaine, lidocaine; Sympathetic nerve system: adrenergic agonist; ephedrine

MeSH Terms

Analgesia*
Anxiety
Blood Pressure
Bupivacaine
Cesarean Section
Ephedrine
Female
Hemodynamics*
Humans
Lidocaine
Pregnancy
Bupivacaine
Ephedrine
Lidocaine