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May 1, 1996Anesthesia & Analgesia

Epidural Test Dose

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Why the study?

Does an intravenous test dose of 3 microgram isoproterenol reliably increase heart rate to detect intravascular injection in adult patients under isoflurane anesthesia?

Population

30 adult patients anesthetized with 1% end-tidal isoflurane and nitrous oxide after endotracheal intubation

Comparison

3 mL of 1.5% lidocaine with 3 microgram… vs 3 mL of normal saline intravenously (IV)

Design

RCT, randomly assigned

Follow-up

4 minutes

Authors

MTMakoto TanakaKanazawa University

Discussion

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Implication

Supports isoproterenol epidural test-dose use under isoflurane; RCT confirms reliable HR detection of intravascular injection.

Structured PICO

Does an intravenous test dose of 3 microgram isoproterenol reliably increase heart rate to detect intravascular injection in adult patients under isoflurane anesthesia?

P
Population
30 adult patients anesthetized with 1% end-tidal isoflurane and nitrous oxide after endotracheal intubation
I
Intervention
3 mL of 1.5% lidocaine with 3 microgram isoproterenol intravenously (IV) to simulate an IV administered test dose
C
Comparator
3 mL of normal saline intravenously (IV)
O
Outcome
Heart rate (HR) and arterial blood pressure changes measured at 20-second intervals for 4 minutes after IV injectionsurrogate

An epidural test dose containing 3 micrograms of isoproterenol is a highly sensitive and specific marker for detecting intravascular injection based on heart rate response during isoflurane anesthesia.

Cite This Study

Makoto Tanaka (1996) studied this question.

synapsesocial.com/papers/6a899672f8670bac6e334c79https://doi.org/10.1213/00000539-199605000-00031
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Intravenous Isoproterenol as a Marker for Epidural Test-Dosing in Children1993 · 54 citations
  2. 2Isoproterenol is an Effective Marker of Intravenous Injection in Laboring Women1989 · 49 citations
  3. 3Reduced β‐adrenoceptor sensitivity in the elderly1979 · 620 citations
  4. 4Epidural Anesthesia and Analgesia in High-risk Surgical Patients1987 · 993 citations
  5. 5Perioperative Morbidity in Patients Randomized to Epidural or General Anesthesia for Lower Extremity Vascular Surgery1993 · 549 citations