Key result
High thoracic levels of epidural anesthesia significantly reduced the peak systolic blood pressure response to an epinephrine test dose compared to the control stage (18 vs 34 mm Hg; P<0.05).
Why the study?
Does a high thoracic level of epidural anesthesia reduce the hemodynamic response to an epinephrine test dose compared to a low thoracic level in adults?
Population
32 adult patients undergoing epidural or combined epidural-general anesthesia
Comparison
High thoracic level of epidural anesthesia with… vs Low thoracic level of epidural anesthesia with…
Design
RCT, randomized to receive 2% lidocaine at either a high or low thoracic level
Authors
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High thoracic epidural blunts epinephrine test-dose BP response; decreases detection sensitivity for intravascular injection and warrants clinical caution.
RCT (n=32)
Does a high thoracic level of epidural anesthesia reduce the hemodynamic response to an epinephrine test dose compared to a low thoracic level in adults?
Absolute Event Rate: 18% vs 34%
p-value: p=<0.05
High thoracic levels of epidural anesthesia decrease the sensitivity of the standard epinephrine test dose for detecting intravascular injection, especially during general anesthesia.
Spencer S. Liu (1996) conducted an RCT in Epidural or combined epidural-general anesthesia (n=32). High thoracic level of epidural anesthesia vs. Control stage / low thoracic level (12 mL) of epidural anesthesia was evaluated on Peak systolic blood pressure response to epinephrine (mm Hg) (p=<0.05). High thoracic levels of epidural anesthesia significantly reduced the peak systolic blood pressure response to an epinephrine test dose compared to the control stage (18 vs 34 mm Hg; P<0.05).
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