Reversal of bupivacaine epidural anesthesia by intermittent epidural injections of crystalloid solutions.
This study was designed to determine whether epidural motor blockade could be reversed by postoperative injections of crystalloid solutions via the epidural catheter. Twenty-seven patients (ASA physical status I, nonlaboring) had epidural anesthesia with 0.75% bupivacaine for elective cesarean delivery. Postoperatively, patients were randomized to receive three 15-mL injections (over 30 min) of crystalloid solutions (normal saline or Ringer's lactate) or no treatment (control) via the epidural catheter. Degree of motor and sensory blockade was evaluated with an investigator blinded to treatment group. Rate of resolution of sensory blockade was not different among groups. However, time for resolution of motor blockade was more than twice as long in the control group than in either treatment group (control = 178 +/- 70 min vs Ringer's lactate = 84 +/- 44 min, normal saline = 70 +/- 38 min, P = 0.001). The data suggest that unwanted motor blockade due to epidural anesthesia can be reversed by epidural injections of crystalloid solutions.
Johnson
M D
MD
Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
Burger
G A
GA
Mushlin
P S
PS
Arthur
G R
GR
Data
S
S
D000328:Adult; D000762:Anesthesia Recovery Period; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local; D002045:Bupivacaine / Q000037:antagonists & inhibitors* / Q000097:blood; D002585:Cesarean Section; D006801:Humans; D007268:Injections, Epidural; D007552:Isotonic Solutions / Q000008:administration & dosage*; D009407:Nerve Block; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D000077325:Ringer's Lactate
D000779:Anesthetics, Local; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D002045:Bupivacaine