Hemodynamic effects of lidocaine in the thoracic paravertebral space during one-lung ventilation for thoracic surgery.
OBJECTIVE
There is increasing interest in the use of the thoracic paravertebral block (TPVB) in association with general anesthesia for lung-resection surgery. The aim of the study was to evaluate the hemodynamic effects of a 5-mg/kg lidocaine bolus injected in the thoracic paravertebral space during one-lung ventilation (OLV) in noncardiac patients undergoing thoracic surgery.


METHODS
Prospective, observational study.


METHODS
Tertiary care university hospital.


METHODS
Twenty patients undergoing thoracotomy for lung resection.


METHODS
In addition to standard monitoring, cardiac output, preload parameters (global diastolic volume, total intrathoracic blood volume, and systolic volume variation), and myocardial contractility (dP(max) and cardiac function index) were measured with an aortic transpulmonary thermodilution technique.


RESULTS
After OLV initiation, a paravertebral lidocaine bolus of 5 mg/kg (2%) caused decreases in the dP(max) and cardiac function index that lasted up to 30 minutes. Accompanying minor reductions in heart rate and systolic blood pressure required no vasoactive drugs and were self-limiting. None of the other hemodynamic parameters studied was significantly altered.


CONCLUSIONS
In noncardiac patients, TPVB is associated with good hemodynamic stability, despite a small and transient decrease in myocardial contractility that could be related to the drug's systemic effects after its absorption.
Garutti
Ignacio
I
Department of Anesthesiology, Reanimation and Intensive Care, Hospital General Universitario Gregorio Marañon, Madrid, Spain. ngarutti@inicia.es <ngarutti@inicia.es>
Olmedilla
Luis
L
Pérez-Peña
Jose María
JM
Arnal
Daniel
D
Piñeiro
Patricia
P
Barrigon
Santos
S
Navia
Juan
J
D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D002302:Cardiac Output / Q000187:drug effects* / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D011013:Pneumonectomy / Q000379:methods; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D013904:Thoracic Vertebrae; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008012:Lidocaine