EurekaMag.com logo
+ Site Statistics
References:
52,725,316
Abstracts:
28,411,598
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on Google+Follow on Google+
Follow on LinkedInFollow on LinkedIn

+ Translate

The effect of epinephrine on small-dose hyperbaric bupivacaine spinal anesthesia: clinical implications for ambulatory surgery






Anesthesia and Analgesia 86(5): 973-977

The effect of epinephrine on small-dose hyperbaric bupivacaine spinal anesthesia: clinical implications for ambulatory surgery

The effect of adding epinephrine to small doses of spinal bupivacaine on the duration of sensory motor block has not been carefully investigated. Twelve volunteers underwent hyperbaric bupivacaine spinal anesthesia (7.5 mg) with and without epinephrine (0.2 mg) in a randomized double-blind, cross-over fashion. Sensory block was assessed with pinprick, transcutaneous electrical stimulation (TES) equivalent to surgical stimulation (at umbilicus, pubis, knee, and ankle), and tolerance of a pneumatic thigh tourniquet. Motor block was assessed with isometric force dynamometry. Discharge criteria were defined as return of pinprick sensation to dermatome S2, ability to ambulate, and ability to urinate. Extent of sensory block to pinprick over time was unaffected by the addition of epinephrine. However, epinephrine prolonged tolerance of TES at the pubis, knee, and ankle (33-48 min, P < 0.05) and of thigh tourniquet (30 min, P < 0.01). Motor block was prolonged by epinephrine at the quadriceps and gastrocnemius muscles (by 23 and 51 min, respectively, P < 0.002). Achievement of discharge criteria was prolonged by 48 min by the addition of epinephrine (P < 0.01). Thus, epinephrine may prolong surgical anesthesia for lower abdominal and lower extremity surgery and delay time until patients achieve discharge criteria. Implications: Using a cross-over study design, 12 volunteers underwent bupivacaine spinal anesthesia with and without epinephrine. This study suggests that adding epinephrine to bupivacaine may prolong surgical anesthesia and also delay patients' discharge.


Accession: 009562028

PMID: 9585279



Related references

Abouleish E.; Rawal N.; W.A.H.; Tobon Randal B.; Meyer B., 1992: A clinical and laboratory study to compare the addition of 02 mg epinephrine 02 mg epinephrine or combination to hyperbaric bupivacaine for spinal anesthesia in cesarean section. Anesthesiology (Hagerstown) 77(3A): A1010

Liu, S.S.; Ware, P.D.; Allen, H.W.; Neal, J.M.; Pollock, J.E., 1996: Dose-response characteristics of spinal bupivacaine in volunteers. Clinical implications for ambulatory anesthesia. Background: Small doses of bupivacaine may be a reasonable choice for spinal anesthesia for patients having ambulatory surgery. However, few dose-response data are available to guide the selection of reasonable doses of bupivacaine for different a...

Hakan Erbay, R.; Ermumcu, O.; Hanci, V.; Atalay, H., 2011: A comparison of spinal anesthesia with low-dose hyperbaric levobupivacaine and hyperbaric bupivacaine for transurethral surgery: a randomized controlled trial. The aim of this study was to compare spinal anesthesia effects of low-dose hyperbaric levobupivacaine and low-dose hyperbaric bupivacaine for transurethral procedures. In this double-blind, randomized, controlled study, a total of 60 patients who...

Kim, W.Ho.; Ko, J.Sangwook.; Ahn, H.Joo.; Choi, S.Joo.; Shin, B.Seop.; Gwak, M.Sook.; Sim, W.Seog.; Yang, M., 2013: Epinephrine decreases the dose of hyperbaric bupivacaine necessary for tourniquet pain blockade during spinal anesthesia for total knee replacement arthroplasty. We quantified the dose-sparing effect of epinephrine by comparing the median effective dose (ED<sub>50</sub>) of intrathecal hyperbaric bupivacaine co-administered with epinephrine with the ED<sub>50</sub> of intrathecal hy...

Imbelloni, L.Eduardo.; Gouveia, M.A., 2014: A comparison of thoracic spinal anesthesia with low-dose isobaric and low-dose hyperbaric bupivacaine for orthopedic surgery: A randomized controlled trial. The thoracic spinal anesthesia was first described in 1909 and recently revised for various surgical procedures. This is a prospective study aims to evaluate the parameters of the thoracic spinal anesthesia (latency, motor block and paresthesia),...

Vercauteren, M.P.; Coppejans, H.C.; Hoffmann, V.L.; Saldien, V.; Adriaensen, H.A., 1998: Small-dose hyperbaric versus plain bupivacaine during spinal anesthesia for cesarean section. In a double-blind, randomized trial, 98 parturients undergoing cesarean section received either hyperbaric or plain bupivacaine 6.6 mg combined with sufentanil 3.3 mug as part of a combined spinal-epidural procedure. To prevent hypotension, 1000 m...

Labbene, I.; Lamine, K.; Gharsallah, H.; Jebali, A.; Adhoum, A.; Ghozzi, S.; Ben-Rais, N.; Ferjani, M., 2007: Spinal anesthesia for endoscopic urological surgery - Low dose vs. varying doses of hyperbaric bupivacaine. Background and objective: The aim of this study is to compare the efficiency of low dose vs. varying doses of hyperbaric bupivacaine in spinal anesthesia for endoscopic urological procedures.Methods: Sixty consecutive patients were studied in a r...

Labbene, I.; Lamine, K.; Gharsallah, H.; Jebali, A.; Adhoum, A.; Ghozzi, S.; Ben Rais, N.; Ferjani, M., 2007: Spinal anesthesia for endoscopic urological surgery--low dose vs. varying doses of hyperbaric bupivacaine. The aim of this study is to compare the efficiency of low dose vs. varying doses of hyperbaric bupivacaine in spinal anesthesia for endoscopic urological procedures. Sixty consecutive patients were studied in a randomized prospective manner. They...

Biboulet, P.; Deschodt, J.; Aubas, P.; Vacher, E.; Chauvet, P.; D'Athis, F., 1993: Continuous spinal anesthesia: does low-dose plain or hyperbaric bupivacaine allow the performance of hip surgery in the elderly?. This study was designed to assess the predictability of 5 mg bupivacaine to give a T10 sensory level when injected subarachnoid in elderly patients. Sixty-five patients aged 75 years or more, scheduled to undergo elective hip surgery, participated...

Abouleish, E.; Rawal, N.; Tobon-Randall, B.; Rivera-Weiss, M.; Meyer, B.; Wu, A.; Rashad, M.N., 1993: A clinical and laboratory study to compare the addition of 0.2 mg of morphine, 0.2 mg of epinephrine, or their combination to hyperbaric bupivacaine for spinal anesthesia in cesarean section. The aim of this prospective, randomized, double-blind study was to compare the effects of adding either preservative-free morphine, 0.2 mg (n = 20), epinephrine, 0.2 mg (n = 21), or a combination of both (n = 29) to hyperbaric bupivacaine in partu...