title: Spinal procaine with and without epinephrine and its relation to transient radicular irritation.
abstract: OBJECTIVE
  To document the clinical characteristics of procaine with or without the addition of epinephrine.
  
  
  METHODS
  In this randomized, prospective, double blind study, 62 patients received spinal anesthesia with 100 mg procaine and either 0.3 mg epinephrine (EPI group) or 0.3 ml NaCl 0.9% (SALINE group). Sensory anesthesia to needle prick was evaluated q 1 min for 10 min, q 3 min for 33 min and q 5 min until regression to L4. Motor block was assessed with the Bromage scale. Patients were questioned, by telephone, for transient radicular irritation (TRI) 48 hr later.
  
  
  RESULTS
  Time to reach highest sensory level and number of segments blocked showed no difference. Mean time for regression of the sensory level to T10 was longer in EPI (83 +/- 23 vs 66 +/- 20 min, P < 0.01). Time to recuperate to full flexion of knees and feet (Bromage 4) was longer in EPI (126 +/- 37 vs 100 +/- 30 min, P < 0.01). Patients in EPI received more ephedrine. Eighteen patients had nausea (15 EPI/3 SALINE, P < 0.0015). One patient had TRI, incidence: 1.67%, 95% CI (< 1%-9%).
  
  
  CONCLUSIONS
  Spinal procaine is appropriate for surgery of short duration. Epinephrine prolongs sensory and motor blocks by 25%. However, it is associated with a high incidence of nausea.
authors.affiliation: Département d'anesthésie-réanimation, Hôpital Maisonneuve-Rosemont and Université de Montréal, Québec, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Bergeron
authors.forename: M
authors.initials: M
authors.lastname: Girard
authors.forename: P
authors.initials: P
authors.lastname: Drolet
authors.forename: Y
authors.initials: Y
authors.lastname: Grenier
authors.forename: H H
authors.initials: HH
authors.lastname: Le Truong
authors.forename: C
authors.initials: C
authors.lastname: Boucher
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D011343:Procaine / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D011343:Procaine; D004837:Epinephrine