Adrenaline-Induced Hypotension in Neurosurgery

Abstract

We have compared the effects of scalp infiltration with 0.5% lignocaine, 0.5% lignocaine with adrenaline 1:200,000, 0.9% saline and 0.9% saline with adrenaline 1:200,000, in a prospective, randomized, double-blind study. Direct arterial pressure, heart rate and bleeding at incision were recorded in 80 patients undergoing craniotomy or craniectomy. Arterial pressure decreased by more than 20% from preinfiltration values in 40% of patients in the saline with adrenaline group, and in 55% of patients in the lignocaine with adrenaline group. It did not decrease in patients who did not receive adrenaline.

Local anesthesia for functional endoscopic sinus surgery employing small volumes of epinephrine‐containing solutions of lidocaine produces profound hypotension

“…Systemic absorption of epinephrine contained in anesthetics occurs and systemic effects of epinephrine are variable and related to blood levels. Epinephrine is the most potent agent which often produces systemic toxicity and epinephrine‐related side‐effects including hypertension, hypotension, tachycardia, bradycardia and other arrhythmia (4–7). So it is important for us to use epinephrine correctly and monitor patients carefully during surgery, especially in patients with cardiac disease.…”

“…Systemic absorption of epinephrine contained in anesthetic occurs and systemic effects of epinephrine are variable and probably related to blood levels. It is important too investigate and understand these effects more accurately because epinephrine‐related side‐effects have caused problems for both patients and doctors (4–7).…”

Marked Hypotension Induced by Adrenaline Contained in Local Anesthetic

“…Vasoconstrictor contained in local anesthetic slows the rate of absorption, reduces toxicity, prolongs duration, and may result in a more profound block. Adrenaline is the most potent agent, which may have potentially catastrophic adverse side effects, according to literature 9,10 . It produces systemic toxicity and should be used with particular care, if at all, in patients with cardiac disease.…”

“…Systemic absorption of the vasoconstrictors contained in anesthetics occurred. Adrenaline‐related side effects, such as hypertension, hypotension, tachycardia, bradycardia, and other arrhythmia, 9–13 caused much trouble to patients, otolaryngologists, and anesthesiologists. Furthermore, adrenaline‐related side effects often cause adverse events.…”

A case of hypotension after intranasal adrenaline infiltration causing a clinical dilemma during the intraoperative period

“…Some studies[12] have concluded that there is no significant haemodynamic changes while others have demonstrated significant transient changes in heart rate and mean arterial pressure. [3–6]…”