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Titolo:
EPINEPHRINE PROLONGS DURATION OF SUBCUTANEOUS INFILTRATION OF LOCAL-ANESTHESIA IN A DOSE-RELATED MANNER
Autore:
LIU S; CARPENTER RL; CHIU AA; MCGILL TJ; MANTELL SA;
Indirizzi:
VIRGINIA MASON MED CTR,DEPT ANESTHESIOL,1100 9TH AVE,POB 900 SEATTLE WA 98111
Titolo Testata:
Regional anesthesia
fascicolo: 5, volume: 20, anno: 1995,
pagine: 378 - 384
SICI:
0146-521X(1995)20:5<378:EPDOSI>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Keywords:
ANESTHESIA; LOCAL; BUPIVACAINE; LIDOCAINE; CAPILLARY BLOOD FLOW; LASER DOPPLER MEASUREMENTS; SYMPATHETIC NERVOUS SYSTEM; VASOCONSTRICTORS; EPINEPHRINE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
S. Liu et al., "EPINEPHRINE PROLONGS DURATION OF SUBCUTANEOUS INFILTRATION OF LOCAL-ANESTHESIA IN A DOSE-RELATED MANNER", Regional anesthesia, 20(5), 1995, pp. 378-384

Abstract

Background and Objectives. Epinephrine is frequently combined with local anesthesia to prolong analgesia. Determination of the minimal concentration and the dose of epinephrine that produces prolongation of analgesia is important in the face of epinephrine's potential for systemic and local toxicity. The authors undertook this study to determine adose-response curve of epinephrine on duration of analgesia of both 1% lidocaine and 0.25% bupivacaine after local infiltration. In order to determine whether epinephrine-induced vasoconstriction affected duration of analgesia, the authors correlated duration of analgesia with magnitude of local vasoconstriction as measured with laser Doppler flowmetry. ii?Methods. Six volunteers were studied in a randomized double-blind manner. Ten skin wheals of 0.2 mL solution were subcutaneously injected into both forearms of each volunteer. The solutions consisted of 1% lidocaine with epinephrine concentrations of 0, 1:50,000, 1:200,000, 1:800,000, and 1:3,200,000, and 0.25% bupivacaine with the same epinephrine concentrations. Duration of loss of sensation Co pinprick at each wheal was recorded. Skin wheals with 0.2 mt of these same solutions were also subcutaneously injected into the abdomen of the same 6 volunteers, and laser Doppler flowmetry readings of skin blood flow were measured for 6 hours after injection. Results. Epinephrine prolonged duration of analgesia for both lidocaine and bupivacaine in a dose-related manner (P < .001). All concentrations of epinephrine attenuatedthe vasodilation observed in the first 15 minutes after injection with plain local anesthesia (P = .03), and blood flow returned to baseline by 30 minutes after injection of either plain or epinephrine-containing solutions. Duration of analgesia correlated with magnitude of vasoconstriction only al the 15-minute measurement (r = .53 and .57, P = .003 and 0.001 for lidocaine and bupivacaine, respectively). Conclusions. Epinephrine prolongs duration of analgesia after local infiltrationin a dose-related manner. Addition of epinephrine in concentrations of 1:50,000 or 1:200,000 increases duration of analgesia after local infiltration by approximately 200%. Addition of doses as dilute as 1:3,200,000 still increases duration of analgesia by approximately 100%. Duration of analgesia appears to correlate with magnitude of epinephrine-induced vasoconstriction using laser Doppler flowmetry. Based on study data, the use of epinephrine in concentrations from 1:200,000 to 1:3,200,000 is recommended for prolongation of analgesia after local infiltration.

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Documento generato il 27/09/20 alle ore 00:00:20