Upper thoracic epidural anaesthesia: effects of age on neural blockade and cardiovascular parameters

Background Segmental dose reduction with increasing age after thoracic epidural anaesthesia (TEA) has been documented. We hypothesised that after a fixed loading dose of ropivacaine at the T3–T4 level, increasing age would result in more extended analgesic spread. In addition, other aspects of neura...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2013-07, Vol.57 (6), p.767-775
Main Authors: WINK, J., WOLTERBEEK, R., AARTS, L. P. H. J., KOSTER, S. C. E., VERSTEEGH, M. I. M., VEERING, B. T. H.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Aging - physiology
Amides - administration & dosage
Amides - pharmacokinetics
Amides - pharmacology
Anesthesia, Epidural - methods
Anesthetics, Local - administration & dosage
Anesthetics, Local - pharmacokinetics
Anesthetics, Local - pharmacology
Blood Pressure - drug effects
Cardiac Output - drug effects
Diffusion
Heart Rate - drug effects
Humans
Middle Aged
Nerve Block
Neural Conduction - drug effects
Pleurodesis
Stroke Volume - drug effects
Thoracic Surgery, Video-Assisted
Thoracic Vertebrae
Thoracotomy
Tissue Distribution
Young Adult
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Summary:Background Segmental dose reduction with increasing age after thoracic epidural anaesthesia (TEA) has been documented. We hypothesised that after a fixed loading dose of ropivacaine at the T3–T4 level, increasing age would result in more extended analgesic spread. In addition, other aspects of neural blockade and haemodynamic changes were studied. Methods Thirty‐five lung surgery patients were included in three age groups. Thirty‐one patients received an epidural catheter at the T3–T4 interspace followed by an injection of 8‐ml ropivacaine 0.75%. Analgesia was assessed with pinprick and temperature discrimination. Motor block was tested using the Bromage and epidural scoring scale for arm movements score. An arterial line was inserted for invasive measurement of blood pressure, cardiac index (CI) and stroke volume (SV). Results There was no influence of age on quality of TEA except for the caudal border of analgesia being somewhat lower in the middle and older age group compared with the young age group. Heart rate (6.0 ± 5.9, P 
ISSN:0001-5172
1399-6576
DOI:10.1111/aas.12087