title: Epinephrine infiltration on nasal field causes significant hemodynamic changes: hypotension episode monitored by impedance-cardiography under general anesthesia.
abstract: OBJECTIVE
  Local infiltration of epinephrine-containing local anesthetics is widely used in clinics particularly in the procedure of surgeries on vascularity field to provide good analgesia and hemostasis. A prospective randomized double blind control study was designed to observe hemodynamic changes caused by local infiltration of epinephrine- containing lidocaine solution on nasal field under general anesthesia.
  
  
  METHODS
  90 adult patients undergoing elective functional endoscopic sinus surgery under general anesthesia were randomly allocated into three groups and received 1% lidocaine 4 mL with different dose of epinephrine (group I 20 microg; group II 40 microg; and group III 0 microg) respectively. Mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI), and acceleration index (ACI) were recorded through impedance-cardiography at every 45 seconds in 6 minutes after the beginning of local infiltration.
  
  
  RESULTS
  Compared with the intra-group baseline, statistically significant hemodynamic changes particularly decrease in MAP with increase in HR at 1.5 minutes time point (P < 0.01), and decrease in SVRI and increase in CI, ACI at and from 1.5 minutes time point (P > 0.05) were observed in group I and group II, but not in group III.
  
  
  CONCLUSIONS
  Local infiltration of epinephrine-containing lidocaine solution on nasal field causes significant decrease in MAP and SVRI, and increase in HR, CI and ACI.
authors.affiliation: Department of Anesthesiology, Jinling Hospital, Nanjing University, Nanjing, P.R. China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Yang
authors.forename: Jun
authors.initials: J
authors.lastname: Zheng
authors.forename: Hong-jun
authors.initials: HJ
authors.lastname: Liu
authors.forename: Yu-Xiu
authors.initials: YX
authors.lastname: Liu
authors.forename: Jin-Chun
authors.initials: JC
authors.lastname: Shen
authors.forename: Zhi-qiang
authors.initials: ZQ
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000772:Anesthesia, Local; D000779:Anesthetics, Local; D001794:Blood Pressure / Q000187:drug effects; D002307:Cardiography, Impedance / Q000187:drug effects*; D004311:Double-Blind Method; D004837:Epinephrine / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014662:Vasoconstrictor Agents / Q000009:adverse effects / Q000494:pharmacology*
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D004837:Epinephrine