Anesth Pain Med.  2016 Jul;11(3):285-290. 10.17085/apm.2016.11.3.285.

Changes of the T-wave on range of spinal blockade after low dose epinephrine administration

• Lee J
• Oh S
• Kim BG
• Han YJ

• KMID: 2344933
• DOI: http://doi.org/10.17085/apm.2016.11.3.285

Abstract

BACKGROUND
Epidural test solution is administered to confirm the correct positioning of an epidural catheter. Hemodynamic changes after administration of epidural test solution reportedly help confirm intravenous (IV) placement of epidural catheters. The change in T wave amplitude is important for checking intravascular placement of epidural catheters. We examined changes in T wave amplitude according to the level of spinal anesthesia after IV epinephrine administration.
METHODS
Eighty-one healthy patients undergoing spinal anesthesia were randomized into three groups: group C (control), group L (low spinal block), and group H (high spinal block). All patients received an IV administration of test solution, 3 ml of 1% lidocaine and epinephrine 10 µg. Systolic blood pressure (SBP), heart rate (HR), and T wave amplitude were measured up to 5 min after test solution administration. Adverse reactions post administration of test solution were also recorded.
RESULTS
In all groups, after administration of IV test solution, SBP and HR increased, and the T wave amplitude decreased. There were no significant differences in HR, SBP, and T wave amplitude changes between the groups after administrating test solution. Fifteen out of 25 patients (60.0%), 10 out of 24 (41.6%), and 11 out of 23 (47.8%) complained of adverse symptoms in groups C, L, and H, respectively.
CONCLUSIONS
This study suggests that change in T wave amplitude after administration of a low dose of epinephrine is not affected by the spinal block range.

Keyword

Electrocardiography; Epinephrine; Lidocaine; Spinal anesthesia

MeSH Terms

Anesthesia, Spinal
Blood Pressure
Catheters
Electrocardiography
Epinephrine*
Heart Rate
Hemodynamics
Humans
Lidocaine
Epinephrine
Lidocaine

Figure

• 

  Fig. 1 Changes in systolic blood pressure. Values are mean ± SD. There is no statistically significant differences between groups. *P < 0.05 compared with baseline time (0 s) in group C, †P < 0.05 compared with baseline time (0 s) in group H.

• 

  Fig. 2 Changes in heart rate. Values are mean ± SD. There is no statistically significant differences between groups. *P < 0.05 compared with baseline time (0 s) in group C, †P < 0.05 compared with baseline time (0 s) in group L, ‡P < 0.05 compared with baseline time (0 s) in group H.

• 

  Fig. 3 Percentage change in T wave amplitude. Values are mean ± SD. There is no statistically significant differences between groups. *P < 0.05 compared with baseline time (0 s) in group C, †P < 0.05 compared with baseline time (0 s) in group L, ‡P < 0.05 compared with baseline time (0 s) in group H.

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