A Comparison of the Hydrochloride and Carbon Dioxide Salts of Lidocaine and Prilocaine in Epidural Analgesia

Abstract

SUMMARY Lumbar epidural blockade has been used in a series of 659 patients to compare the analgesic properties of lidocaine and prilocaine. Solutions of both compounds were compared as hydrochloride salts in 2% and 3% concentration with and without adrenaline 1:200,000. Solutions of base, made soluble by equilibration with carbon dioxide at a pC02 of 700 mm Hg were also compared in concentrations of 1.75% for lidocaine and 1.71% for prilocaine. Comparisons were based on measurements of latency, spread of analgesia, intensity of motor blockade and duration of analgesia. The quality of blockade in all the test solutions was increased by the addition of 1:200,000 adrenaline. Prilocaine has a slow latency compared with lidocaine, but in plain solution its duration is longer than that of lidocaine. The 3% hydrochloride solutions have no practical advantage over die 2% solutions for epidural blockade. Analgesia resulting from the C02‐base solutions is superior in every respect to the blockade produced by equivalent concentrations of the hydrochloride salts.

A comparative study of patient controlled epidural analgesia (PCEA) and continuous infusion epidural analgesia (CIEA) during labour

“…12 Sensory analgesia was determined by loss of sensation to cold, using ice, and the degree of motor block was assessed clinically, using Bromage's scale. 13 Patients were assessed at 30 minutes after epidural insertion and then at hourly inteta, als. Maternal blood pressure was measured every five minutes after the epiduml insertion, for 15 minutes, and then every 30 minutes.…”

Comparison of two different doses of magnesium sulphate for spinal anaesthesia: a prospective, randomized double-blind study

“…The motor level was assessed according to modified Bromage score: (0 = no motor loss; 1= inability to flex the hip; 2 = inability to flex the knee joint; 3 = inability to flex the ankle). 9 The motor block onset time was defined as the time interval from the completion of IT injection to the onset of Bromage 3 score and duration of motor block to return of Bromage score 3 to 0.…”

Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine on Spinal Block Characteristics in Gynecological Procedures: A Double Blind Controlled Study

“…The sensory block level was assessed by cold alcohol swap along the midclavicular line bilaterally. The motor block was assessed according to the modified Bromage scale [8] : Bromage 0, the patient is able to move the hip, knee and ankle; Bromage 1, the patient is unable to move the hip but is able to move the knee and ankle; Bromage 2, the patient is unable to move the hip and knee but able to move the ankle; Bromage 3, the patient is unable to move the hip, knee and ankle. The times to reach T10 dermatome sensory block, peak sensory level and Bromage 3 motor block were recorded before surgery.…”