The Effects of Epinephrine on Lidocaine Spinal Anesthesia

Intrathecal fentanyl-induced pruritus is more severe in combination with procaine than with lidocaine or bupivacaine

“…1,2 The addition of fentanyl to lidocaine and bupivacaine spinal anesthesia has also been shown to enhance the blocks with a prolongation of duration similar to that obtained with the addition of epinephrine, but without urinary retention. [3][4][5] Pruritus as a side ef-fect has been perceived as minimal with intrathecal lidocaine and bupivacaine combinations with fentanyl. We have reported the use of subarachnoid fentanyl to potentiate procaine spinal anesthesia 6 and found that, unlike previous reports of minimal side effects with lidocaine and bupivacaine, 54% of the patients had severe itching, with 7 of 16 requiring treatment in the postanesthesia care unit (PACU) as their block was resolving.…”

A fully implanted drug delivery system for peripheral nerve blocks in behaving animals

“…It is commonly thought to improve nerve blocks by constricting the blood vessels and slowing systemic absorption, thus allowing the anesthetic more time to diffuse through the epineurium (Covino, 1986). However, it is not typically believed to be essential, and its benefits are controversial (Chambers et al, 1981; Chambers et al, 1982; Chiu et al, 1995; Kito et al, 1998). It is possible that the metabolism of the rhesus macaque is sufficiently high as to prevent any significant amount of anesthetic to cross the epineurium without the extra time provided by epinephrine.…”

Prospective comparison of continuous femoral nerve block with nonstimulating catheter placement versus stimulating catheter-guided perineural placement in volunteers ,

“…[13][14][15] In a study focus- Tolerance to repeated TES of the 17 volunteers with successful bilateral continuous femoral nerve blocks throughout the 12-hour study period. Comparison of the overall significance of tolerance to repeated stimuli between the SC and the NSC groups was determined by analysis of variance for repeated measures (P ϭ .009).…”

“…TES has previously been used in volunteer studies to assess cutaneous pain thresholds during spinal anesthesia. 13 TES was initially delivered at 10 mA and incrementally increased by 10 mA until each subject described mild discomfort to the delivered TES current output. The highest current tolerated without mild discomfort was recorded as "baseline."…”