Korean J Anesthesiol.  2008 Mar;54(3):256-260. 10.4097/kjae.2008.54.3.256.

Effect of Normal Saline and Distilled Water Used for Dilution of 4% Plain Lidocaine in Epidural Anesthesia

• Kim JH
• Ryu SJ
• Yu SB
• Kim KH
• Chang TH
• Kim SH

• KMID: 2239809
• DOI: http://doi.org/10.4097/kjae.2008.54.3.256

Abstract

BACKGROUND: Lidocaine blocks sodium channels in nerve membranes, which inhibits sodium influx and prevents development of an action potential. For epidural anesthesia, we usually use lidocaine diluted in normal saline or distilled water. However, diluents containing sodium ions may affect lidocaine activity.
METHODS
Fifty patients, ASA physical status class I or II, scheduled for elective epidural anesthesia were randomly divided into two groups.For epidural anesthesia, we used 14 ml of 2% lidocaine solution made with 7 ml of 4% lidocaine plus an equivalent of distilled water (Group DW) or normal saline (Group NS).In the right lateral decubitus position, a 19 G Arrow catheter was inserted 3 cm in the cephalad direction in the L3-4 intervertebral space.In the supine position, 3 ml of 2% lidocaine was injected as a test dose, and the remaining 11 ml of lidocaine was injected 2 minutes later.We used a pinprick test for evaluation of sensory block levels and a Bromage grade for degrees of motor block every 2 minutes during the first 30 minutes.
RESULTS
Levels of sensory block were higher in Group DW than Group NS at 12, 14 and 30 minutes. The degree of motor block was also higher in Group DW at 12 and 14 minutes.
CONCLUSIONS
Diluent containing sodium ions reduces sensory and motor block compared to sodium-free solution in epidural anesthesia.

Keyword

epidural; anesthesia; lidocaine; motor block; sensory block; sodium

MeSH Terms

Action Potentials
Anesthesia
Anesthesia, Epidural
Catheters
Humans
Ions
Lidocaine
Membranes
Organic Chemicals
Sodium
Sodium Channels
Supine Position
Water
Ions
Lidocaine
Organic Chemicals
Sodium
Sodium Channels
Water