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Plasma Concentrations of Lidocaine and Its Principal Metabolites During Continuous Epidural Infusion of Lidocaine With or Without Epinephrine

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Observational analysis evaluates lidocaine absorption in epidural anesthesia, suggesting limited effectiveness of epinephrine.

Lidocaine concentrations were higher in the group receiving lidocaine alone for the first 30 minutes.
Plasma levels of MEGX were significantly greater in the lidocaine-only group, indicating altered metabolism.
Continuous infusion showed equivalent lidocaine levels after one hour, demonstrating epinephrine's ineffectiveness over time.
After two hours, the addition of epinephrine did not reduce systemic toxicity potential, calling for caution.

Kihara et al. (1999) studied this question.

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