Document Detail

Lidocaine and bupivacaine exert differential effects on whole blood coagulation.
MedLine Citation:
PMID:  10396719     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVES: To compare bupivacaine to lidocaine's effects on blood clotting at two concentrations, and to characterize and determine relative effects of two equianalgesic bupivacaine and lidocaine concentrations. DESIGN: Prospective, dual-controlled, whole blood equal volume admixture thrombelastographic (TEG) study. SETTING: University of Pennsylvania Medical Center operating rooms. PATIENTS: 20 ASA physical status I and II patients' blood comprised control groups and anesthetic groups. INTERVENTIONS: Analysis of whole blood clotting used six TEG channels for untreated and saline controls and four final concentrations (1.0% lidocaine, 0.5% lidocaine, 0.25% bupivacaine, and 0.125% bupivacaine) of local anesthetics. Saline control and the local anesthetic-treated specimens underwent 8.3% hemodilution. MEASUREMENTS AND MAIN RESULTS: Blood was studied. Saline control or four anesthetic solutions (30 microliters) were added in random order two 5 TEG cuvettes. Whole blood (330 microliters) was mixed ex vivo at 37 degrees C. A sixth channel with untreated whole blood (360 microliters) acted as an undiluted control. Data for four TEG parameters [reaction time (r), angle (alpha), maximum amplitude (MA), and percent decrease in TEG amplitude from MA 30 minutes after MA acquisition (Lysis 30)] for undiluted control and saline volumetric controls were compared to each other using Student's t-test for paired observations. Lidocaine and bupivacaine groups' TEGs were compared to the paired saline control analysis of variance for repeated measures. A p-value less than 0.05 was considered significant. There was no difference between whole blood and saline control TEGs. All local anesthetics produced significant hypocoagulable changes from control. Angle alpha and MA were significantly decreased in all local anesthetic groups. Ther time was prolonged only in the high lidocaine-treated blood. Lysis was a feature of the low lidocaine and bupivacaine solutions. Equianalgesic lidocaine produced more profound hypocoagulable effects than did bupivacaine. CONCLUSIONS: Lidocaine and bupivacaine both significantly impaired TEG coagulation in a concentration-dependent manner. Lidocaine was significantly more hypocoagulable than bupivacaine at two similarly analgesic concentrations.
M D Tobias; C Henry; Y G Augostides
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  11     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-09-14     Completed Date:  1999-09-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  52-5     Citation Subset:  IM    
Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
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MeSH Terms
Analysis of Variance
Anesthetics, Local*
Blood Coagulation / drug effects*
Dose-Response Relationship, Drug
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine; 2180-92-9/Bupivacaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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