| Norepinephrine and ephedrine do not counteract the increase in cutaneous microcirculation induced by spinal anaesthesia. | |
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MedLine Citation:
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PMID: 20576631 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Neuraxial anaesthesia improves tissue perfusion and tissue oxygen tension. Vasodilation induced by this technique may result in hypotension requiring the administration of vasoactive drugs. The use of peripheral vasoconstrictors might counteract the improved tissue perfusion and its potentially beneficial effects. We therefore investigated the effect of i.v. norepinephrine and ephedrine on skin perfusion using laser-Doppler flowmetry (LDF) in patients during spinal anaesthesia. METHODS: Skin blood flow expressed in perfusion units (PU) provided by LDF was measured simultaneously at the foot and the manubrium levels in 44 patients during spinal anaesthesia with a sensory level below T5. Norepinephrine infusion was then titrated to normalize mean arterial pressure (MAP) in 23 patients (Group NOR). Ephedrine (max. 10 mg) was administered in 21 patients (Group EPH). Changes in relative PU were compared between the two sites of measurements in each group during drug administration. The same doses of norepinephrine were assessed in 11 normal volunteers to assure comparable vasoreactivity at the foot and manubrium levels. RESULTS: Spinal anaesthesia resulted in a 10% decrease in MAP (P<0.001), an increase in relative PU values at the foot level (P<0.001), and a decrease at the sternum level (P<0.05). Norepinephrine and ephedrine produced a significant increase in relative PU values at the foot level when compared with the sternum level (NOR: P=0.02; EPH: P=0.0035). In volunteers, norepinephrine decreased cutaneous perfusion similarly at the manubrium and foot levels. CONCLUSIONS: Improved skin perfusion induced by spinal anaesthesia was not counteracted by the use of norepinephrine or ephedrine. |
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Authors:
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J-P H Lecoq; J-F Brichant; M L Lamy; J L Joris |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2010-06-24 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 105 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-14 Completed Date: 2010-08-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 214-9 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia and Intensive Care Medicine, CHU de Liège, Domaine du Sart Tilman, Liège, Belgium. jplecoq@chu.ulg.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anesthesia, Spinal / adverse effects* Blood Pressure / drug effects Ephedrine / administration & dosage, pharmacology Heart Rate / drug effects Humans Hypotension / drug therapy, etiology*, physiopathology Laser-Doppler Flowmetry Microcirculation / drug effects Middle Aged Norepinephrine / administration & dosage, pharmacology Skin / blood supply* Vasoconstrictor Agents / administration & dosage, pharmacology* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Vasoconstrictor Agents; 299-42-3/Ephedrine; 51-41-2/Norepinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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