Epinephrine, potassium and the electrocardiogram during regional anaesthesia

Hahn, Robert G.; Löfgren, A.

doi:10.1046/j.1365-2346.2000.00625.x

Cited by 3 publications

(3 citation statements)

References 11 publications

(12 reference statements)

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“…One of the most reliable hypotheses is that the change in T wave amplitude is caused by hypokalemia [18] or stimulation of -adrenaline receptors [19]. Epinephrine can induce hypokalemia with resultant T wave changes on ECG [20].…”

Section: Discussionmentioning

confidence: 99%

Changes of the T-wave on range of spinal blockade after low dose epinephrine administration

Lee

Kim

et al. 2016

Anesth Pain Med

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Epidural test solution is administered to confirm the correct positioning of an epidural catheter. Hemodynamic changes after administration of epidural test solution reportedly help confirm intravenous (IV) placement of epidural catheters. The change in T wave amplitude is important for checking intravascular placement of epidural catheters. We examined changes in T wave amplitude according to the level of spinal anesthesia after IV epinephrine administration. Methods: Eighty-one healthy patients undergoing spinal anesthesia were randomized into three groups: group C (control), group L (low spinal block), and group H (high spinal block). All patients received an IV administration of test solution, 3 ml of 1% lidocaine and epinephrine 10 g. Systolic blood pressure (SBP), heart rate (HR), and T wave amplitude were measured up to 5 min after test solution administration. Adverse reactions post administration of test solution were also recorded. Results: In all groups, after administration of IV test solution, SBP and HR increased, and the T wave amplitude decreased. There were no significant differences in HR, SBP, and T wave amplitude changes between the groups after administrating test solution. Fifteen out of 25 patients (60.0%), 10 out of 24 (41.6%), and 11 out of 23 (47.8%) complained of adverse symptoms in groups C, L, and H, respectively. Conclusions: This study suggests that change in T wave amplitude after administration of a low dose of epinephrine is not affected by the spinal block range. (Anesth Pain Med 2016; 11: 285-290)

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Section: Discussionmentioning

confidence: 99%

Changes of the T-wave on range of spinal blockade after low dose epinephrine administration

Lee

Kim

et al. 2016

Anesth Pain Med

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“…However, it appears to occur by hypokalemia or the activation of β-adrenaline receptors [15-17]. Stimulation of the sympathetic nervous system causes an increase in the secretion of endogenous catecholamine, which causes a change in the T-wave amplitude [18-20].…”

Section: Discussionmentioning

confidence: 99%

The change of T-wave on electrocardiogram after epinephrine test dose in spinal anesthetized adults

Lee

Kim

Choi

et al. 2010

Korean J Anesthesiol

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BackgroundThis study evaluated the efficacy of a T-wave change after the IV administration of low dose epinephrine containing the test dose during spinal anesthesia.MethodsEighty healthy adults undergoing spinal anesthesia were enrolled in this study. The subjects were divided randomly into the following 4 groups: Group S (n = 20) received 3 ml of normal saline, group L (n = 20) received 3 ml of 1.0% lidocaine, group E5 received 3 ml of 1.0% lidocaine with epinephrine 5 µg, and group E10 received 3 ml of 1.0% lidocaine with epinephrine 10 µg. The heart rate (HR) and T-wave amplitude were measured with an electrocardiogram and systolic blood pressure (SBP) using a non-invasive method. Positive responses were defined as an increase in HR ≥ 20 bpm or SBP ≥ 15 mmHg, or a decrease in the T-wave amplitude ≥ 25%.ResultsThe sensitivity (Ss), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of the HR increases were 80%, 100%, 100%, and 83%, respectively, in groups E5 and E10. For the SBP increases, the Ss, Sp, PPV, and NPV were respectively, 55%, 100%, 100%, and 70% in group E5, and 80%, 100%, 100%, and 83% in group E10. For the ≥ 25% decrease in T-wave amplitude, Ss, Sp, PPV, and NPV were respectively, 100%, 90%, 91%, and 100% in group E5, and 95%, 90%, 90%, and 95% in group E10.ConclusionsThese results suggest that a change in the T-wave amplitude is useful for detecting the unintentional IV administration of low dose epinephrine during CSEA.

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“…Local use of epinephrine also causes hypokalemia and ECG changes. (Hahn and Lofgren 2000; Kubota et al 1993)…”

Section: Current Problems and Barriers In Therapeutic Hypometabothmentioning

confidence: 99%

Strategies for therapeutic hypometabothermia

Liu¹,

Chen²

2012

Journal of Experimental Stroke and Translational Medicine

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Although therapeutic hypothermia and metabolic suppression have shown robust neuroprotection in experimental brain ischemia, systemic complications have limited their use in treating acute stroke patients. The core temperature and basic metabolic rate are tightly regulated and maintained in a very stable level in mammals. Simply lowering body temperature or metabolic rate is actually a brutal therapy that may cause more systemic as well as regional problems other than providing protection. These problems are commonly seen in hypothermia and barbiturate coma. The main innovative concept of this review is to propose thermogenically optimal and synergistic reduction of core temperature and metabolic rate in therapeutic hypometabothermia using novel and clinically practical approaches. When metabolism and body temperature are reduced in a systematically synergistic manner, the outcome will be maximal protection and safe recovery, which happen in natural process, such as in hibernation, daily torpor and estivation.

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Epinephrine, potassium and the electrocardiogram during regional anaesthesia

Cited by 3 publications

References 11 publications

Changes of the T-wave on range of spinal blockade after low dose epinephrine administration

Changes of the T-wave on range of spinal blockade after low dose epinephrine administration

The change of T-wave on electrocardiogram after epinephrine test dose in spinal anesthetized adults

Strategies for therapeutic hypometabothermia

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