title: Haemodynamic monitoring during alkalinized lignocaine epidural block: a comparison with subarachnoid anaesthesia.
abstract: Cardiovascular responses after epidural alkalinized lignocaine and subarachnoid hyperbaric bupivacaine administration were studied using a non-invasive cardiac output measurement in 32 ASA Grade I-II patients undergoing orthopaedic leg surgery (hip hemi-arthroplasty or Ender nailing). All patients achieved adequate surgical anaesthesia. The block onset time was faster (P = 0.003), and the range of final sensory level wider (P = 0.006) in patients receiving spinal anaesthesia compared with the epidural group. Diastolic arterial pressure was significantly reduced when compared with base-line (P = 0.002) only in the spinal group. No significant changes in stroke volume, systemic vascular resistance or left ventricular stroke work were observed in either group. Heart rate and cardiac index were significantly reduced in the spinal group when compared both with base line (P = 0.002; P = 0.04) and the epidural group (P = 0.001; P = 0.006). The results demonstrated that the block onset time and the cardiovascular effects produced by lumbar epidural anaesthesia, with alkalinized solutions, remain less than after spinal anaesthesia involving the same segments.
authors.affiliation: Department of Anaesthesiology and Intensive Care, University of Milan, IRCCS H San Raffaele, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Casati
authors.forename: G
authors.initials: G
authors.lastname: Fanelli
authors.forename: P
authors.initials: P
authors.lastname: Beccaria
authors.forename: G
authors.initials: G
authors.lastname: Aldegheri
authors.forename: M
authors.initials: M
authors.lastname: Berti
authors.forename: M
authors.initials: M
authors.lastname: Agostoni
authors.forename: G
authors.initials: G
authors.lastname: Torri
mesh_terms: D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D001794:Blood Pressure; D002302:Cardiac Output; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007866:Leg / Q000601:surgery; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D014655:Vascular Resistance; D016277:Ventricular Function, Left
chemical_list: D008012:Lidocaine