Epidural anaesthesia attenuates the catecholamine response to hypoventilation.
The effect of a high epidural block on the catecholamine response to hypoventilation was studied in six unanesthetized dogs given intravenous sufentanil (15 micrograms.kg-1). Sufentanil alone resulted in a increase of norepinephrine (NE) concentration from 108 +/- 73 pg.ml-1 to 843 +/- 399 pg.ml-1 and epinephrine (E) from 279 +/- 80 pg.ml-1 to 2010 +/- 1416 pg.ml-1. At least one week later, an epidural block to T1 was achieved using 8-10 ml, two per cent lidocaine. Plasma NE and E decreased after EA to about 50 per cent of resting baseline measurements. The addition of sufentanil increased NE and E levels to reach approximately the resting base-line levels. In all dogs intravenous sufentanil resulted in bradypnoea, bradycardia, hypoxaemia, and hypercarbia. Intravenous lidocaine infusions had no significant effect on plasma catecholamine levels when plasma lidocaine levels ranged from 1.7 micrograms.ml-1 to 5.3 micrograms.ml-1. We conclude that a high two per cent lidocaine epidural block attenuates the catecholamine response to hypoventilation in dogs, but the persistence of baseline plasma levels of NE and E suggests that the efferent sympathetic block by high EA is incomplete.
Stevens
R A
RA
Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814.
Lineberry
P J
PJ
Arcario
T J
TJ
Bacon
G S
GS
Cress
L W
LW
D000767:Anesthesia, Epidural; D000771:Anesthesia, Intravenous; D000777:Anesthetics / Q000494:pharmacology*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D004285:Dogs; D004837:Epinephrine / Q000097:blood*; D005260:Female; D005283:Fentanyl / Q000031:analogs & derivatives* / Q000494:pharmacology; D006339:Heart Rate / Q000187:drug effects; D007040:Hypoventilation / Q000097:blood*; D008012:Lidocaine / Q000097:blood / Q000494:pharmacology*; D009638:Norepinephrine / Q000097:blood*; D010100:Oxygen / Q000097:blood; D012119:Respiration / Q000187:drug effects; D017409:Sufentanil
D000777:Anesthetics; D002245:Carbon Dioxide; D008012:Lidocaine; D017409:Sufentanil; D010100:Oxygen; D005283:Fentanyl; D009638:Norepinephrine; D004837:Epinephrine