| Efficacy of an epidural test dose in adult patients anesthetized with isoflurane: lidocaine containing 15 micrograms epinephrine reliably increases arterial blood pressure, but not heart rate. | |
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MedLine Citation:
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PMID: 7818118 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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When continuous epidural anesthesia is combined with general anesthesia, the only objective sign of intravascular migration of the epidural catheter are the increments of heart rate (HR) or arterial blood pressure after a local anesthetic test dose containing epinephrine. However, the efficacy of a simulated intravenous (IV) test dose in adult patients under general anesthesia has not been determined. Thirty adult patients were randomly assigned to one of two groups, each of which was anesthetized with 1% end-tidal isoflurane and nitrous oxide after endotracheal intubation. The epinephrine group (n = 15) was given 3 mL of 1.5% lidocaine with epinephrine (1:200,000) IV to simulate an IV administered epidural test dose. The saline group (n = 15) was identical to epinephrine group, but received 3 mL of normal saline IV. HR and arterial blood pressure were measured at 20-s intervals for 4 min after IV injection. In the epinephrine group, significant increases in HR compared with the baseline value were observed from 40 to 80 s after the IV test dose with a mean maximum HR increase of 24 +/- 2 bpm (mean +/- SEM) occurring at 48 +/- 3 s. However, 5 of 15 patients in the epinephrine group developed HR increments smaller than 20 bpm (sensitivity 67%). Since HRs were essentially unchanged in the saline group, specificity, positive predictive value (+PV), and negative predictive value (-PV) were 100%, 100%, and 75%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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M Tanaka; S Yamamoto; H Ashimura; M Iwai; N Matsumiya |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 80 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 1995 Feb |
Date Detail:
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Created Date: 1995-02-09 Completed Date: 1995-02-09 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 310-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesia/Critical Care Medicine, Tsuchiura Kyodo General Hospital, Ibaraki-ken, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthesia, General* Blood Pressure / drug effects* Epinephrine / administration & dosage, pharmacology* Female Heart Rate / drug effects* Humans Isoflurane* Lidocaine / administration & dosage* Male Nitrous Oxide* Sensitivity and Specificity Systole |
| Chemical | |
Reg. No./Substance:
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10024-97-2/Nitrous Oxide; 137-58-6/Lidocaine; 26675-46-7/Isoflurane; 51-43-4/Epinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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