Concentration of lidocaine affects intensity of sensory block during lumbar epidural anesthesia. 1999

S Sakura, and M Sumi, and H Kushizaki, and Y Saito, and Y Kosaka
Department of Anesthesiology, Shimane Medical University, Izumo City, Japan. ssakura@shimane-med.ac.jp

We investigated the effects of a twofold difference in concentration and volume of lidocaine on lumbar epidural block using a cutaneous current perception threshold (CPT) quantitative sensory testing device. Twenty ASA I patients scheduled for elective gynecological surgery were randomly divided into two equal groups to receive either 20 mL of 1% lidocaine or 10 mL of 2% lidocaine through an epidural catheter inserted at the L1-2 interspace. CPTs at 2000-, 250-, and 5-Hz stimulation and sensation to light touch, temperature, and pinprick at ipsilateral dermatomes V, T9, and L2 were measured before and every 5 min until 60 min after the epidural lidocaine. Epidural anesthesia with both solutions produced a significant increase in all CPTs at dermatomes T9 and L2. Alterations in CPTs were similar for both groups at T9 but were significantly greater in patients given 2% lidocaine than in those given 1% lidocaine at L2. There were no differences in the upper level of sensory block to cold, pinprick, and touch between the two groups. We conclude that lumbar epidural anesthesia with 10 mL of 2% lidocaine produces more intense blockade of both large- and small-diameter sensory nerve fibers than that with 20 mL of 1% lidocaine. CONCLUSIONS The effects of local anesthetic concentration and volume on the quality of epidural anesthesia have not been adequately investigated. The results of the present study suggest that the concentration affects the intensity of sensory block during epidural anesthesia with lidocaine.

UI MeSH Term Description Entries
D008012 Lidocaine A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE. Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D008161 Lumbosacral Region Region of the back including the LUMBAR VERTEBRAE, SACRUM, and nearby structures. Lumbar Region,Lumbar Regions,Lumbosacral Regions,Region, Lumbar,Region, Lumbosacral,Regions, Lumbar,Regions, Lumbosacral
D008619 Mepivacaine A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168) Carbocaine,Carbocaïne,Isocaine,Isogaine,Meaverin,Mecain,Mepihexal,Mepivacain-Injektopas,Mepivacaina Braun,Mepivacaine Hydrochloride,Mepivacaine Monohydrochloride,Mepivastesin,Polocaine,Scandicain,Scandicaine,Scandinibsa,Scandonest,Mepivacain Injektopas
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010092 Oximetry The determination of oxygen-hemoglobin saturation of blood either by withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry. Pulse Oximetry,Oximetry, Pulse,Oximetries,Oximetries, Pulse,Pulse Oximetries
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
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

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