Effect of thoracic epidural bupivacaine 0.75% on somatosensory evoked potentials after dermatomal stimulation. 1990

J B Dahl, and J Rosenberg, and C Lund, and H Kehlet
Department of Anesthesia, Hvidovre University Hospital, Copenhagen, Denmark.

The effect of thoracic epidural bupivacaine 0.75%, 9 ml, on early (less than 500 ms) somatosensory evoked potentials (SEPs) during electrical stimulation of the T10 and L1 dermatomes was examined in ten patients. Spread of analgesia (pinprick) was T3.7 +/- 0.5 to L2.5 +/- 1 (mean +/- SEM). Peak-to-peak amplitudes of the T10 SEPs were reduced (p less than 0.05) while an insignificant reduction was found in L1 stimulated potentials. SEPs were abolished in four and two patients at the T10 and L1 levels, respectively. The latency of the early SEP components (0, P1-3, N1-3) increased (p less than 0.05) at T10 but was not significant at L1 except for N2 and N3. Sensory threshold increased significantly in both stimulation areas during blockade. In conclusion, thoracic epidural administration of 9 ml of bupivacaine 0.75% does not provide total afferent somatic blockade despite sensory analgesia to pinprick.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009475 Neurons, Afferent Neurons which conduct NERVE IMPULSES to the CENTRAL NERVOUS SYSTEM. Afferent Neurons,Afferent Neuron,Neuron, Afferent
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D004558 Electric Stimulation Use of electric potential or currents to elicit biological responses. Stimulation, Electric,Electrical Stimulation,Electric Stimulations,Electrical Stimulations,Stimulation, Electrical,Stimulations, Electric,Stimulations, Electrical
D005073 Evoked Potentials, Somatosensory The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM. Somatosensory Evoked Potentials,Evoked Potential, Somatosensory,Somatosensory Evoked Potential
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012867 Skin The outer covering of the body that protects it from the environment. It is composed of the DERMIS and the EPIDERMIS.

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