EFFECT OF I.V. LOW-DOSE ADRENALINE AND PHENYLEPHRINE INFUSIONS ON PLASMA CONCENTRATIONS OF BUPIVACAINE AFTER LUMBAR EXTRADURAL ANAESTHESIA IN ELDERLY PATIENTS

Thirty patients undergoing primary total hip replacement under lumbar extradural anaesthesia with 0.75% bupivacaine 25 ml were allocated randomly to receive either low-dose adrenaline or phenylephrine infusions i.v. throughout surgery. Haemodynamic measurements and arterial blood samples were obtain...

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Bibliographic Details
Published in:British Journal of Anaesthesia 1991-12, Vol.67 (6), p.694-698
Main Authors: SHARROCK, N.E., GO, G., MINEO, R.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anaesthetic techniques: extradural
Anaesthetics
Anesthesia, Epidural
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Bupivacaine - blood
Cardiac Output - drug effects
Epinephrine - pharmacology
Female
Fluid Therapy
Heart: cardiac output
Hemodynamics - drug effects
Hip Prosthesis
Humans
local: bupivacaine
Male
Medical sciences
Middle Aged
Neuropharmacology
Pharmacology. Drug treatments
Phenylephrine - pharmacology
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Summary:Thirty patients undergoing primary total hip replacement under lumbar extradural anaesthesia with 0.75% bupivacaine 25 ml were allocated randomly to receive either low-dose adrenaline or phenylephrine infusions i.v. throughout surgery. Haemodynamic measurements and arterial blood samples were obtained before the extradural injection and at 10, 20, 30, 40, 50, 60 and 90 min thereafter. Peak arterial plasma concentrations of bupivacaine were observed 10 min after extradural anaesthesia and were significantly lower in patients receiving adrenaline infusions. Cardiac output was significantly greater in patients receiving adrenaline infusions (P < 0.01). It is postulated that the smaller circulating concentrations of bupivacaine observed in patients receiving adrenaline were caused by increased cardiac output and a greater volume of distribution than in patients receiving phenyl-ephrine.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/67.6.694