title: The effect of epidural anaesthesia with 1% lidocaine on the pressor response to dynamic exercise in man.
abstract: 1. In order to examine the sensitivity to local anaesthetics of afferent neural feedback from working muscle during dynamic exercise, sixteen subjects cycled for 12 min before and after epidural anaesthesia using 1% lidocaine. The presence of afferent neural blockade was verified by elimination of the blood pressure response to a cold pressor test, laser-induced evoked potentials and increases in pain detection and tolerance thresholds of the foot. Conversely, epidural anaesthesia had no effect on these variables in the unblocked skin areas or on electrically evoked potentials in blocked or unblocked skin. 2. During dynamic exercise, heart rate increased as did mean arterial pressure and cardiac output. Mean arterial pressure remained at the exercise level during post-exercise ischaemia, but heart rate and cardiac output decreased while total peripheral resistance increased. Epidural anaesthesia did not significantly affect these variables during rest, dynamic exercise, post-exercise ischaemia or recovery. 3. The results of this study show that, in order to affect blood pressure during dynamic exercise, epidural anaesthesia must block the pressor response to post-exercise ischaemia. The implication of these data is that complete or almost complete block of group III and/or group IV muscle afferents is necessary to inhibit the pressor response to dynamic exercise in man.
authors.affiliation: Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: D B
authors.initials: DB
authors.lastname: Friedman
authors.forename: J
authors.initials: J
authors.lastname: Brennum
authors.forename: F
authors.initials: F
authors.lastname: Sztuk
authors.forename: O B
authors.initials: OB
authors.lastname: Hansen
authors.forename: P S
authors.initials: PS
authors.lastname: Clifford
authors.forename: F W
authors.initials: FW
authors.lastname: Bach
authors.forename: L
authors.initials: L
authors.lastname: Arendt-Nielsen
authors.forename: J H
authors.initials: JH
authors.lastname: Mitchell
authors.forename: N H
authors.initials: NH
authors.lastname: Secher
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D001642:Bicycling; D001794:Blood Pressure / Q000187:drug effects*; D002302:Cardiac Output / Q000187:drug effects; D003080:Cold Temperature; D004558:Electric Stimulation; D004594:Electrophysiology; D005071:Evoked Potentials / Q000187:drug effects; D015444:Exercise / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007511:Ischemia / Q000503:physiopathology; D007834:Lasers; D008012:Lidocaine; D008297:Male; D010147:Pain Measurement / Q000187:drug effects; D012026:Reflex, Stretch / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D008012:Lidocaine