title: Increased haemodilution in hypotension induced by epidural anaesthesia.
abstract: This study examined whether the increased haemodilution from fluid loading in patients who develop hypotension at the onset of epidural anaesthesia (EDA) can be explained by high-level blockade or by stress-induced elevation of the blood glucose concentration. In 20 men aged between 53 and 87, crystalloid volume loading was carried out with 10 ml.kg-1 b.w. and EDA was induced with mepivacaine 2% and adrenaline 1:200,000. Irrespective of the blood pressure reaction to the blockade, there was no change in blood glucose level. A strong linear correlation between haemodilution and arterial pressure was found, in spite of unchanged blood glucose levels, in 10 patients in whom EDA was induced with bupivacaine 0.5%, and in 10 patients who received spinal anaesthesia with tetracaine 1%. There was no correlation between the haemodilution and the extent of sensory analgesia. These results support the view that low arterial pressure alone triggers the increased haemodilution observed during EDA-induced hypotension.
authors.affiliation: Department of Anaesthesiology, Huddinge University Hospital, Sweden.
authors.forename: R G
authors.initials: RG
authors.lastname: Hahn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000775:Anesthesia, Spinal; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001810:Blood Volume / Q000187:drug effects / Q000502:physiology*; D002045:Bupivacaine / Q000097:blood / Q000494:pharmacology; D006438:Hemodilution; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000503:physiopathology; D007022:Hypotension / Q000097:blood / Q000209:etiology* / Q000503:physiopathology*; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008619:Mepivacaine / Q000009:adverse effects / Q000097:blood / Q000494:pharmacology*; D008875:Middle Aged; D013748:Tetracaine / Q000097:blood / Q000494:pharmacology
chemical_list: D001786:Blood Glucose; D006454:Hemoglobins; D007552:Isotonic Solutions; C028570:Ringer's acetate; D013748:Tetracaine; D008619:Mepivacaine; D002045:Bupivacaine