title: [Heart rate response to intravenous atropine during cervical and lumbar epidural anesthesia].
abstract: The authors evaluated the effect of cervical and lumbar epidural anesthesia on the heart rate response to intravenous atropine 0.01 mg.kg-1 in conscious humans with cervical epidural anesthesia (n = 40), with lumbar epidural anesthesia (n = 15) and without epidural anesthesia (n = 25). During cervical and lumbar epidural anesthesia using 1.5% lidocaine, levels of loss of cold sensation were C3-T7 and T7-S1, respectively. Heart rate increased by 14 +/- 10% (mean +/- SD) and 20 +/- 14% after intravenous atropine 0.01 mg.kg-1 in the patients with cervical and lumbar epidural anesthesia, respectively. These magnitudes of positive chronotropic effects were significantly less as compared with those in the patients without epidural anesthesia (32 +/- 11%). Nine of 40 patients (23%) with cervical epidural anesthesia showed heart rate increases of less than 3 beats.min-1 following atropine 0.01 mg.kg-1. And 30 of 40 patients (75%) required supplementary atropine 0.01 mg.kg-1 to increase heart rate for more than 20 beats.min-1 from baseline values. The present study suggests that the heart rate response to intravenous atropine is blunted in patients during cervical and lumbar epidural anesthesia, and that a larger dose of intravenous atropine may be required to accelerate the heart rate in most patients during cervical epidural anesthesia.
authors.affiliation: Department of Anesthesiology, Tsukuba University Hospital.
authors.forename: S
authors.initials: S
authors.lastname: Inomata
authors.forename: T
authors.initials: T
authors.lastname: Nishikawa
authors.forename: S
authors.initials: S
authors.lastname: Sato
authors.forename: S
authors.initials: S
authors.lastname: Saito
authors.forename: H
authors.initials: H
authors.lastname: Naito
mesh_terms: D000328:Adult; D000367:Age Factors; D000767:Anesthesia, Epidural; D001285:Atropine / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine; D008297:Male; D008875:Middle Aged
chemical_list: D001285:Atropine; D008012:Lidocaine