Document Detail

Sympathetic block during spinal anesthesia in volunteers using lidocaine, tetracaine, and bupivacaine.
MedLine Citation:
PMID:  9223197     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Spinal anesthesia to high thoracic dermatomes is alleged to result in almost complete block of all sympathetic efferent nerves. To examine the degree of sympathectomy during spinal anesthesia, the sympathetic response to a cold pressor test (CPT) applied to unblocked dermatomes before and during spinal anesthesia was measured with use of three different local anesthetics. METHODS: Twelve healthy volunteers were studied in a randomized and double-blind fashion on three separate occasions. In random order, each volunteer received approximately equipotent spinal doses of tetracaine 15 mg, bupivacaine 15 mg, and lidocaine 100 mg in hyperbaric solutions. Prior to and 30 minutes after spinal injection of local anesthetic, a CPT was applied for 2 minutes, and changes from baseline resting conditions in five physiologic variables were measured. RESULTS: The CPT 1 given before anesthetic administration resulted in an increase in heart rate, mean arterial pressure, cardiac index, and plasma concentrations of norepinephrine and epinephrine. Spinal anesthesia to a median level of T3 resulted in a decrease in mean arterial pressure by 10-12% but did not significantly decrease the other variables. Spinal anesthesia did not change the increase in heart rate or cardiac index in response to the second CPT, but the increase in mean arterial pressure was attenuated compared to the CPT before anesthesia. No increase in norepinephrine or epinephrine concentration was observed during the CPT given during spinal anesthesia. There was no significant relationship between level of analgesia and sympathetic response to stress. CONCLUSIONS: Spinal anesthesia with hyperbaric solutions of tetracaine 15 mg, bupivacaine 15 mg, and lidocaine 100 mg attenuated sympathetic function but did not produce complete sympathectomy. The effects were independent of the local anesthetic used.
R A Stevens; K Frey; S S Liu; T C Kao; M Mikat-Stevens; D Beardsley; S Holman; J L White
Related Documents :
984477 - Alterations of normal left ventricular performance by general anesthesia.
3863897 - Clinical assessment of etomidate for outpatient general anesthesia: a preliminary evalu...
17468737 - Can a patient be successfully prepared for pheochromocytoma surgery in three days? a ca...
10422937 - Sevoflurane increases lumbar cerebrospinal fluid pressure in normocapnic patients under...
1989427 - Blood pressure lowering in elderly subjects: a double-blind crossover study of omega-3 ...
19868877 - Studies on the respiratory mechanism in lobar pneumonia : a study of lung volume in rel...
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Regional anesthesia     Volume:  22     ISSN:  0146-521X     ISO Abbreviation:  Reg Anesth     Publication Date:    1997 Jul-Aug
Date Detail:
Created Date:  1997-08-14     Completed Date:  1997-08-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7707549     Medline TA:  Reg Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  325-31     Citation Subset:  IM    
Department of Anesthesiology, Loyola University Stritch School of Medicine, Maywood, Illinois, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anesthesia, Spinal*
Anesthetics, Local / pharmacology*
Autonomic Nerve Block*
Bupivacaine / pharmacology
Catecholamines / blood
Cold Temperature
Double-Blind Method
Hemodynamics / drug effects
Lidocaine / pharmacology
Tetracaine / pharmacology
Reg. No./Substance:
0/Anesthetics, Local; 0/Catecholamines; 137-58-6/Lidocaine; 2180-92-9/Bupivacaine; 94-24-6/Tetracaine

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

Previous Document:  Effect of thoracic epidural anesthesia on spontaneous postinfarction ventricular dysrhythmia in awak...
Next Document:  Patterns of pain induced by distending the thoracic zygapophyseal joints.