[The spread of thoracic epidural anesthesia].
The spread of a test dose in epidural anesthesia provides many important informations. The current study was performed to evaluate the possibility that early and quick detection method of block level by the test dose of 2% lidocaine 2 ml. Forty patients undergoing elective surgery were studied regarding the spread of continuous epidural anesthesia performed in T9-10 interspace. The block levels were assessed by skin vasodilatation, loss of goose flesh reflex, and loss of cold as well as pin-prick sensation. Extent of loss of goose flesh reflex was found for 7.7 +/- 2.2 dermatomes by 2% lidocaine 2 ml and, for 14.1 +/- 4.3 dermatomes by 2% lidocaine 5 ml after the test dose. Incomplete but extensive sympathetic block was obtained by the test dose in this study. For the purpose of early detection of the spread of sympathetic block, loss of goose flesh reflex and skin vasodilatation were the most reliable objective clinical signs. However, this sympathetic block by the test dose was not enough to produce circulatory changes.
Department of Anesthesiology, Daiichi Hospital, Nippon Medical School, Tokyo.
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Omi
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Yokoyama
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural; D001340:Autonomic Nerve Block; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D012018:Reflex; D012879:Skin Physiological Phenomena; D014018:Tissue Distribution; D014664:Vasodilation
D008012:Lidocaine