| Epidural saline solution prior to local anaesthetic produces differential nerve block. | |
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MedLine Citation:
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PMID: 10021958 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The loss-of-resistance technique is generally used to identify the epidural space usually with normal saline. However, the effect of epidural saline on anaesthetic spread has not been demonstrated. The purpose of this study was to determine whether epidural saline affected the anaesthetic level and the quality of analgesia. METHODS: Seventy patients undergoing upper abdominal surgery received thoracic epidural anaesthesia combined with general anaesthesia. The patients were randomly allocated into three groups using epidural saline volumes of 1, 5, or 10 ml. Ten minutes after epidural injection of 12 ml mepivacaine 1%, the dermatome levels of hypaesthesia for cold and pinprick were determined by an individual blinded to the amount of saline administered. RESULTS: The levels of hypaesthesia for cold sensation were not different among the three groups (23 [14-44] total bilateral dermatomes blocked with 1 ml saline, 22 [16-41] dermatomes with 5 ml, and 24 [10-36] dermatomes with 10 ml (median [range])). However, the larger volume of saline produced decreased spread of hypaesthesia for pinprick (22 [4-41] dermatomes blocked bilaterally for 1 ml vs 16 [8-24] dermatomes for 10 ml group, P < 0.004). CONCLUSION: Our results suggest that a large volume of saline solution injected in the epidural space to elicit loss-of-resistance dilutes the local anaesthetic solution, resulting in reduced spread of the block to pinprick. |
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Authors:
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T Okutomi; S Hoka |
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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: Canadian journal of anaesthesia = Journal canadien d'anesthésie Volume: 45 ISSN: 0832-610X ISO Abbreviation: Can J Anaesth Publication Date: 1998 Nov |
Date Detail:
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Created Date: 1999-04-27 Completed Date: 1999-04-27 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: CANADA |
Other Details:
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Languages: eng Pagination: 1091-3 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Kitasato University School of Medicine, Kanagawa, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen
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surgery Analgesia, Epidural Anesthesia, Epidural* Anesthesia, General Anesthetics, Local / administration & dosage* Cold Temperature Epidural Space Humans Hypesthesia / chemically induced Injections, Epidural Mepivacaine / administration & dosage* Middle Aged Nerve Block* Pain Threshold / drug effects Sensation / drug effects Sensory Thresholds / drug effects Single-Blind Method Sodium Chloride / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Local; 7647-14-5/Sodium Chloride; 96-88-8/Mepivacaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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