The effect of pH adjustment of 0.5% bupivacaine on the latency of epidural anesthesia. 1989

R A Stevens, and W L Chester, and J A Grueter, and A Schubert, and D Brandon, and B Clayton, and L Spitzer
Department of Anesthesiology, Naval Hospital, Bethesda, MD 20814.

pH adjustment of lidocaine and 2-chloroprocaine has been reported to decrease the latency of epidural anesthesia (EA). The effect of alkalinization of bupivacaine on onset of surgical anesthesia has not been adequately studied to date. To determine what effect raising the pH of 0.5% bupivacaine has on the latency of EA in patients undergoing lower extremity surgery, we performed a randomized, double-blind study. Forty patients were randomly divided into two groups. Group I patients received 15 ml of a local anesthetic (LA) solution containing 0.5% bupivacaine and 0.15 mEq of NaHCO3. Group II patients received 15 ml of a standard solution of 0.5% bupivacaine. Both solutions contained freshly added epinephrine (1:200,000). After injection of LA via Tuohy needle, sensory testing was conducted using a safety pin. The pH of the LA used for Group I was 6.96 +/- 0.01 and for Group II was 5.33 +/- 0.11. No statistically significant difference was found between the anesthetic parameters tested in each group. On this basis, we find no advantage of pH adjustment of 0.5% bupivacaine for EA.

UI MeSH Term Description Entries
D007717 Knee A region of the lower extremity immediately surrounding and including the KNEE JOINT.
D011930 Reaction Time The time from the onset of a stimulus until a response is observed. Response Latency,Response Speed,Response Time,Latency, Response,Reaction Times,Response Latencies,Response Times,Speed, Response,Speeds, Response
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
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006863 Hydrogen-Ion Concentration The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH pH,Concentration, Hydrogen-Ion,Concentrations, Hydrogen-Ion,Hydrogen Ion Concentration,Hydrogen-Ion Concentrations
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
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D001639 Bicarbonates Inorganic salts that contain the -HCO3 radical. They are an important factor in determining the pH of the blood and the concentration of bicarbonate ions is regulated by the kidney. Levels in the blood are an index of the alkali reserve or buffering capacity. Bicarbonate,Bicarbonate Ions,Hydrogen Carbonates,Bicarbonate Ion,Carbonic Acid Ions,Hydrogen Carbonate,Carbonate, Hydrogen,Carbonates, Hydrogen,Ion, Bicarbonate,Ions, Bicarbonate,Ions, Carbonic Acid
D012964 Sodium A member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. Sodium Ion Level,Sodium-23,Ion Level, Sodium,Level, Sodium Ion,Sodium 23
D017693 Sodium Bicarbonate A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. Baking Soda,Carbonic Acid Monosodium Salt,Sodium Hydrogen Carbonate,Bicarbonate, Sodium,Hydrogen Carbonate, Sodium,Soda, Baking

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