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Titolo:
Reversal of lidocaine with epinephrine epidural anesthesia using epidural saline washout
Autore:
Sitzman, BT; DiFazio, CA; Playfair, PA; Stevens, RA; Hanes, CF; Herman, TB; Yates, HK; Leisure, GS;
Indirizzi:
Mayo Clin, Dept Anesthesiol & Pain Management, Jacksonville, FL 32224 USA Mayo Clin Jacksonville FL USA 32224 anagement, Jacksonville, FL 32224 USA Univ Virginia, Hlth Sci Ctr, Dept Anesthesiol, Charlottesville, VA 22908 USA Univ Virginia Charlottesville VA USA 22908 Charlottesville, VA 22908 USA Northwestern Univ, Dept Anesthesiol, Chicago, IL 60611 USA Northwestern Univ Chicago IL USA 60611 Anesthesiol, Chicago, IL 60611 USA
Titolo Testata:
REGIONAL ANESTHESIA AND PAIN MEDICINE
fascicolo: 3, volume: 26, anno: 2001,
pagine: 246 - 251
SICI:
1098-7339(200105/06)26:3<246:ROLWEE>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLOOD PATCH; BUPIVACAINE; ANALGESIA; SPACE;
Keywords:
anesthesia techniques; epidural; local anesthetic; lidocaine; reversal; 0.9% NaCl;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Sitzman, BT Mayo Clin, Dept Anesthesiol & Pain Management, 4500 San Pablo Rd, Jacksonville, FL 32224 USA Mayo Clin 4500 San Pablo Rd Jacksonville FL USA 32224 2224 USA
Citazione:
B.T. Sitzman et al., "Reversal of lidocaine with epinephrine epidural anesthesia using epidural saline washout", REG ANES PA, 26(3), 2001, pp. 246-251

Abstract

Background and Objectives: Prolonged motor and sensory block following epidural anesthesia can be associated with extended postoperative care unit stays and patient dissatisfaction. Previous studies have demonstrated a more rapid motor recovery following the administration of epidural crystalloids in patients who had received plain bupivacaine and lidocaine epidural anesthesia. However, epinephrine is commonly added to local anesthetics to improve the quality and prolong the duration of the epidural block. The objective of this study was to determine the relationship of 0.9% NaCl epidural catheter flush volume (i.e., washout) to the recovery of motor and sensory block in patients undergoing 2% lidocaine with epinephrine epidural anesthesia. Methods: A prospective. randomized, double-blind study design was utilized. Thirty-three subjects scheduled for elective gynecologic or obstetrical surgical procedures underwent epidural anesthesia using 2% lidocaine with epinephrine (1:200,000). A T4 dermatome level of analgesia, determined by toothpick prick, was maintained intraoperatively. Following surgery, subjects were randomized to 1 of 3 treatment groups. Group 1 (control, n = 11) received no epidural 0.9% NaCl (normal saline [NS]) postoperatively. Group 2 (15mL NS X 1, n = 10) received an epidural bolus of 15 mL NS. Group 3 115 mL NS x 2, n = 12) received an epidural bolus of 15 mt NS postoperatively and a second 15-mL NS bolus 15 minutes later. Assessment of motor and sensory block was performed at 15-minute intervals until complete motor and sensory recovery. Results: Times to partial and full motor and sensory recovery were significantly faster in the epidural NS groups than in the control group. Full motor recovery was more rapid in subjects receiving two 15-mL NS epidural NS boluses (30 mL total) compared with those receiving a single 15-mL. NS bolus(108 +/- 9 min v 136 +/- 13 min) and significantly faster than control group subjects (153 +/- 14 min). Both NS X 1 and NS x 2 epidural bolus groups experienced significantly reduced times to complete sensory recovery when compared with the control group INS X 1 = 154 +/- 13 min, NS x 2 = 153 +/- 9min, control 195 +/- 14 min). Conclusions: A more rapid recovery of motor and sensory block in patients undergoing 2% lidocaine with epinephrine epidural anesthesia can be achieved with the use of 30 mt NS epidural washout.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 09:28:52