title: Epidural anaesthesia for caesarean section: comparison of two injection techniques.
abstract: Two techniques of injection for epidural anaesthesia for Caesarean sections were studied. Forty-five patients were randomly divided into two groups. Patients in Group I received 20 ml of lidocaine two per cent with epinephrine via the needle at a rate of 5 ml.30 sec-1 after a 3 ml test dose. Patients in Group II received the same dose of the same solution in increments of 5 ml injected through a catheter after a 3 ml test-dose. Each increment was injected in one minute with a delay of two minutes between injections. Top-up doses were given in both groups to obtain a T4 sensory level. There was no difference between the two groups in the quality of sensory block before delivery. However, the quality was significantly better in Group II after delivery (P = 0.02). The incidence of hypotension was 52.2 per cent in Group I and 13.6 per cent in Group II (P = 0.014). There was no significant difference in maternal and umbilical venous lidocaine concentrations. We conclude that injection in fractional doses is a safer and more efficient technique for epidural anaesthesia for Caesarean section.
authors.affiliation: Départment d'Anesthésie, Hôspital de l'Enfant-Jésus, Université Laval, Québec.
authors.forename: C T
authors.initials: CT
authors.lastname: Crochetière
authors.forename: C A
authors.initials: CA
authors.lastname: Trépanier
authors.forename: J J
authors.initials: JJ
authors.lastname: Coté
mesh_terms: D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D002408:Catheters, Indwelling; D002585:Cesarean Section; D002986:Clinical Trials as Topic; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage* / Q000097:blood; D011183:Postoperative Complications; D011247:Pregnancy; D011897:Random Allocation
chemical_list: D008012:Lidocaine; D004837:Epinephrine