Canadian Journal of Anesthesia, Vol 30, 174-178, Copyright © 1983 by Canadian Anesthesiologists' Society

Clinical Reports: Epidural Anaesthesia with Mixtures of Bupivicaine and Lidocaine

¹ Department of Anaesthesia, The Montreal General Hospital, McGill University, Montréal, Québec

Address Correspondence to: Dr. D.A. Magee, Department of Anaesthesia, Regional Hospital, Newcastle, Galway, Ireland.

In a randomized double-blind trial in 30 patients receiving lumbar epidural anaesthesia, the onset and duration of sensory blockade with 0.375 per cent bupivicaine was compared with a mixture of 0.375 per cent bupivicaine and one per cent lidocaine hydrochloride and a mixture of 0.375 per cent bupivicaine and one per cent carbonated lidocaine. Onset (9.3 ± 1.16 minutes) and complete spread (23.3 ±4.8 minutes) for bupivicaine was significantly slower than in the mixtures containing carbonated lidocaine (onset 4.7 ± 0.48 minutes, complete spread 14.8 ± 2.49 minutes) and lidocaine hydrochloride (onset 5.0 ± 0.67 minutes, complete spread 16.3 ± 3.2 minutes). There was no significant difference in times of onset and complete spread between the two mixtures. The duration of sensory blockade for bupivicaine alone (165 ± 20 minutes) was not significantly ifferent from the duration in either the mixture containing carbonated lidocaine (161 ± 51.24 minutes) or lidocaine hydrochloride (143 ±33.7 minutes).

The results indicate a clinical advantage in speed of onset without significant shortening of duration of action for mixtures of carbonated lidocaine or lidocaine hydrochloride with bupivicaine as compared to bupivicaine alone.

Key Words: ANAESTHETIC TECHNIQUES, REGIONAL: epidural • ANAESTHETICS LOCAL: lidocaine, carbonated lidocaine, bupivicaine, compounding