Why the study?
Does alkalinized lidocaine with epinephrine increase the decrease in systolic blood pressure compared to nonalkalinized lidocaine with epinephrine in patients undergoing elective cesarean section?
Does alkalinized lidocaine with epinephrine increase the decrease in systolic blood pressure compared to nonalkalinized lidocaine with epinephrine in patients undergoing elective cesarean section?
Alkalinization of lidocaine with epinephrine for epidural anesthesia during cesarean section is associated with a significantly greater and faster decrease in systolic blood pressure.
Answers are grounded in this paper and cite their sources.
May warrant closer BP monitoring with alkalinized lidocaine-epinephrine epidurals; leaves open confirmation in randomized trials.
The onset of epidural anesthesia is accelerated by alkalinization of lidocaine with added epinephrine (LE). The possibility that decreases in systolic blood pressure (SBP) are also enhanced was studied in 21 patients having elective cesarean sections. Ten patients given LE + NaHCO3 (0.1 mEq/ml anesthetic solution) compared with 11 given LE alone had significantly (P less than 0.05) greater decreases in SBP (32% vs 19% from baseline values), as well as a greater rate of SBP decline to those minimum values (9%/min vs 3%/min, respectively). These differences were noted despite the fact that patients given LE + HCO3 received no less ephedrine and no more additional anesthetic than controls. Possible adverse effects of SBP reduction on uteroplacental blood flow suggest that caution be used in the use of alkalinized LE in obstetrical patients.
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Parnass et al. (1987) studied this question.
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