Cardiovascular Effects of Epidural Block Combined With General Anaesthesia

Stephen, G.W.; Lees, M. M.; Scott, D.B.

doi:10.1093/bja/41.11.933

Cited by 28 publications

(14 citation statements)

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“…crystalloid. Only two patients in Group P required supplemental ephedrine, whereas there were nine such cases in Group E. These results correlate well with previous findings in patients with epidural blocks (6–8).…”

Section: Discussionsupporting

confidence: 91%

“…Rapid and painless recovery is the main advantage of combining general anesthesia with epidural techniques. However, this combination causes more severe hypotension than is observed with either method alone (6–8). The reason for this larger drop in pressure is that the negative inotropic effect of general anesthesia is augmented by the peripheral vasodilatation effect of epidural anesthesia.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the catheter‐technique psoas compartment block and the epidural block for analgesia in partial hip replacement surgery

Türker

Uckunkaya

Yavaşçaoğlu

et al. 2002

Acta Anaesthesiol Scand

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Comparison of the catheter‐technique psoas compartment block and the epidural block for analgesia in partial hip replacement surgery

Türker

Uckunkaya

Yavaşçaoğlu

et al. 2002

Acta Anaesthesiol Scand

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“…The cardio-vascular effects of epidural block combined with N20 general anaesthesia were studied by Stephen et al (84). Following thiopentone induction, an epidural catheter was inserted, four control measurements of cardiac output were made and, following injection of 30 ml of 2% lidocaine (plain), repeat measurements of cardiac output every 2 minutes were made for 20 minutes, i.e.…”

Section: Vii) Effects During Nitrous Oxide Supplementationmentioning

confidence: 99%

The Cardiorespiratory Effects of Thoracic Epidural Anaesthesia

Wahba¹,

Craig²,

Don³

et al. 1973

Survey of Anesthesiology

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The cardio-respiratory effects of a thoracic epidural anaesthetic as is given for pain relief following upper abdominal surgery were examined in thirteen surgical patients studied in the immediate pre-operative period.following an overnight fast and without premedication.The focus of interest was on its effects on FRC and on gas exchange (measured as A-aD02 and OS/OT%), waich have not been previously reported. AlI subjects were given 10 ml/Kg glucose in saline I.V. during the pre-epidural periode Lidocaine 1.5% was used in aIl cases, plain lidocaine for the first eight and lidocaine with epinephrine 1/200,.000 in the other five subjects. This agent was given to achieve a sensory block to both pin-prick and ice up to T4. Neither FRC nor gas exchange showed any consistent changes following the epidural anaesthetic. These findings are in keeping with what was anticipated from a consideration of the basic physiology and pharmacology concerned and with a review of the pertinent literature. following an overnight fast and without premedication.The focus of interest was on its effects on FRC and on gas exChange (measured as A-aD02 and OS/OT%), which have not been previously reported. All subjects were given 10 ml/Kg glucose in saline I.V. during the ~re-epidural periode Lidocaine 1.5%was used in all cases, plain lidocaine for the first eight and lidocaine with epinephrine 1/200~OOO in the other five subjects. This agent was given to achieve a sensory block to both pin-prick and ice up to T4. Neither FRC nor gas exchange showed any consistent Changes following the epidural anaesthetic. These findings are in keeping with what was anticipated from a consideration of the basic physiology and pharmacology concerned and with a rev~ew of the pertinentliterature.w. MELEIKA~WAHBA' M.Sc. Exp. Red.

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“…The combination of general anaesthesia and epidural blockade with local anaesthetics tends to cause greater hypotension than that observed with either technique alone [1]. In order to maintain blood pressure, the concentration of inhalation anaesthetic may be reduced, and a sympathomimetic drug may be given.…”

mentioning

confidence: 99%

Effect of ephedrine on auditory‐evoked potentials during light general anaesthesia

et al. 2000

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SummaryEphedrine, a sympathomimetic drug, may stimulate the central nervous system via its amphetamine-like effect under light general anaesthesia. We compared the effect of ephedrine on auditory-evoked potentials with that of etilefrine, a sympathomimetic drug that lacks an amphetamine-like effect, in patients undergoing abdominal surgery under general anaesthesia with 67% nitrous oxide in oxygen and epidural blockade. Ephedrine (0.08 mg.kg À1 intravenously) signi®cantly decreased the latencies of Nb and P 1 from 49.5 (4.2) [mean (SD)] and 63.9 (9.1) ms to 45.9 (4.2) and 59.0 (9.9) ms, respectively; whereas etilefrine (0.02 mg.kg À1 intravenously) caused no signi®cant changes in these potentials. In addition, the latencies of Nb and P 1 before drug administration were positively correlated with patient age. These ®ndings suggest that ephedrine can cause excitation of the central nervous system during light general anaesthesia, and that auditory-evoked potentials may be a sensitive indicator of the depth of anaesthesia.

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Cardiovascular Effects of Epidural Block Combined With General Anaesthesia

Cited by 28 publications

References 0 publications

Comparison of the catheter‐technique psoas compartment block and the epidural block for analgesia in partial hip replacement surgery

Comparison of the catheter‐technique psoas compartment block and the epidural block for analgesia in partial hip replacement surgery

The Cardiorespiratory Effects of Thoracic Epidural Anaesthesia

Effect of ephedrine on auditory‐evoked potentials during light general anaesthesia

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