title: Hemodynamic effects of lidocaine in the thoracic paravertebral space during one-lung ventilation for thoracic surgery.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Reanimation and Intensive Care, Hospital General Universitario Gregorio Marañon, Madrid, Spain. ngarutti@inicia.es <ngarutti@inicia.es>
authors.forename: Ignacio
authors.initials: I
authors.lastname: Garutti
authors.forename: Luis
authors.initials: L
authors.lastname: Olmedilla
authors.forename: Jose María
authors.initials: JM
authors.lastname: Pérez-Peña
authors.forename: Daniel
authors.initials: D
authors.lastname: Arnal
authors.forename: Patricia
authors.initials: P
authors.lastname: Piñeiro
authors.forename: Santos
authors.initials: S
authors.lastname: Barrigon
authors.forename: Juan
authors.initials: J
authors.lastname: Navia
mesh_terms: 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
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine