Haemodynamic monitoring during alkalinized lignocaine epidural block: A comparison with subarachnoid anaesthesia

A. Casati, G. Fanelli, P. Beccaria, G. Aldegheri, M. Berti, M. Agostoni, G. Torri

Research output: Contribution to journalArticlepeer-review

Abstract

Cardiovascular responses after epidural alkalinized lignocaine and subarachnoid hyperbaric bupivacaine administration were studied using a non-invasive cardiac output measurement in 32 ASA Grade I-II patients undergoing orthopaedic leg surgery (hip hemiarthroplasty or Ender nailing). All patients achieved adequate surgical anaesthesia. The block onset time was faster (P = 0.003), and the range of final sensory level wider (P = 0.006) in patients receiving spinal anaesthesia compared with the epidural group. Diastolic arterial pressure was significantly reduced when compared with base-line (P = 0.002) only in the spinal group. No significant changes in stroke volume, systemic vascular resistance or left ventricular stroke work were observed in either group. Heart rate and cardiac index were significantly reduced in the spinal group when compared both with base-line (P = 0.002; P = 0.04) and the epidural group (P = 0.001; P = 0.006). The results demonstrated that the block onset time and the cardiovascular effects produced by lumbar epidural anaesthesia, with alkalinized solutions, remain less than after spinal anaesthesia involving the same segments.

Original languageEnglish
Pages (from-to)300-306
Number of pages7
JournalEuropean Journal of Anaesthesiology
Volume14
Issue number3
Publication statusPublished - May 1997

Keywords

  • Anaesthesia, epidural, spinal
  • Cardiovascular system, effects
  • Local anaesthetic, alkalinized lignocaine, bupivacaine
  • Measurement techniques, transthoracic electrical impedance

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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