Canadian Journal of Anesthesia, Vol 21, 523-534, Copyright © 1974 by Canadian Anesthesiologists' Society

Etidocaine: A Clinical Evaluation for Regional Analgesia in Surgery

¹ Departments of Anaesthesia, Royal Victoria Hospital and McGill University, Montreal, Canada

The new long-acting local anaesthetic etidocaine ("Duranest", Astra) was assessed for regional analgesia using a qualitative and quantitative scoring system established for other local anaesthetic agents. Two hundred and thirty-two blocks were performed, using 1 per cent etidocaine for 196 epidural anaesthetics, and 0.5 per cent etidocaine with 1/200,000 epinephrine for 36 cases of supraclavicular brachial plexus blockade. No untoward reactions or dural punctures were encountered in this series.

Analgesia developed rapidly in both epidural and brachial plexus blockade. The mean latency for lumbar epidural block was 10.85 minutes, and 8.7 minutes for supraclavicular block. The segmental spread of epidural analgesia was highly predictable, and segmental dose requirements were 50 per cent less than those needed for lidocaine. Motor block was intense, and complete immobility of the legs usually accompanied lumbar epidural analgesia. The duration of blockade was rather unpredictable and a wide variance was encountered with both epidural and brachial plexus analgesia. The mean duration for recession of two segments in epidural analgesia was 170 minutes (S.D. = ±57 minutes), while the mean duration of brachial plexus blockade was 572 (S.D. = ±203 minutes). The quality of epidural blockade was markedly influenced by the presence or absence of a vasoconstrictor. One per cent plain etidocaine gave slower onset of epidural analgesia, shorter duration and less intense quality of sensory and motor blockade than the solution with 1/200,000 epinephrine.

The practical applications of etidocaine for regional analgesia are discussed in the light of these findings.