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Canadian Journal of Anesthesia, Vol 46, 935-938, Copyright © 1999 by Canadian Anesthesiologists' Society

ARTICLES

Saline-anesthetic interval and the spread of epidural anesthesia

T Okutomi and S Hoka
Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

PURPOSE: To examine the effect of modifying the interval between administration of saline used during the loss of resistance (LOR) method and local anesthetic on epidural anesthetic level and its quality. METHODS: Seventy-three patients who received thoracic epidural anesthesia were randomly allocated into three groups; the 2, 5 and 10 min groups, according to the interval between the administration of saline and 8 ml mepivacaine 1.5%. Fifteen minutes after the mepivacaine injection, the dermatome level of hypesthesia was determined by an individual blinded to the interval. RESULTS: When the saline-anesthetic interval was prolonged, the hypesthetic levels for coldness and pinprick were decreased. The number of spinal segments with hypesthesia for coldness were 15 [12-20]#, 12.5 [10.5-22.5]## and 10.5 [6.5-15.5]### in the 2, 5 and 10 min groups, respectively (median [range], # P < 0.05 vs the 5 min group, ## P < 0.05 vs the 10 min group, ### P < 0.05 vs the 2 min group). The number of spinal segments with hypesthesia for pinprick were 13.5 [11-18]#, 11 [7.5-20.5]## and 10 [5.5-13]### in the 2, 5 and 10 min groups, respectively. There were differences in all groups between the number of segments with hypesthesia for coldness and pinprick elicited. CONCLUSION: The interval between the administration of saline and local anesthetic alters the anesthetic level and quality of epidural analgesia.


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Copyright © 1999 by the Canadian Anesthesiologists' Society.