Complications Associated with Continuous Epidural Analgesia

Wu, Christopher L.; Richman, Jeffrey M.

doi:10.1016/b978-1-4160-2392-0.50022-4

Cited by 3 publications

(1 citation statement)

References 112 publications

(136 reference statements)

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“…Several large observational studies reported incidences of migration of the epidural catheter into a blood vessel of 0–0.67% and 0.25% (Wu and Ouanes 2013; Pan et al 2004). Accidental intravenous local anesthetic infusion due to catheter migration can cause sudden cardiovascular collapse (Wong et al 2010; Khan and Khadijah 2008).…”

Section: Introductionmentioning

confidence: 99%

Hypocapnia delays subsequent bupivacaine cardiotoxicity in rats under sevoflurane anesthesia

Mochizuki

Katoh

et al. 2014

SpringerPlus

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BackgroundHypocapnia induced following the accidental intravenous infusion of a local anesthetic can mitigate anesthetic toxicity, but the effects of hypocapnia induced prior to local anesthetic infusion are unknown. In this study, we examined the effects of prior hypocapnia on bupivacaine-induced cardiotoxicity in rats.MethodsEighteen Sprague–Dawley rats were randomly divided into two groups: one receiving sevoflurane with normal ventilation (Control Group) and the other receiving sevoflurane with hyperventilation to induce hypocapnia (Hypocapnia Group). After 30 min, both groups received continuous intravenous infusions of 0.25% bupivacaine at 2 mg · kg−1 · min−1. The time taken to reach 25% and 50% reductions in heart rate (HR; HR-25%, HR-50%) and mean arterial pressure (MAP; MAP-25%, MAP-50%) from the start of bupivacaine infusion were recorded. The difference between HR-25% and MAP-25% was calculated. The times of the first ventricular premature beat (VPB) and final systole were also recorded.ResultsIn the Hypocapnia Group, HR-50%, MAP-25%, and MAP-50% were prolonged compared with the Control Group (P < 0.001). Furthermore, the interval between HR-25% and MAP-25% and the times between the first VPB and final systole were prolonged in the Hypocapnia Group (P < 0.001).ConclusionIn rats under sevoflurane anesthesia, prior hypocapnia delayed the onset of bupivacaine-induced cardiotoxicity. Prior hypocapnia should be avoided during continuous bupivacaine nerve block under general anesthesia, because it may delay the detection of cardiotoxicity.

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Section: Introductionmentioning

confidence: 99%

Hypocapnia delays subsequent bupivacaine cardiotoxicity in rats under sevoflurane anesthesia

Mochizuki

Katoh

et al. 2014

SpringerPlus

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Epidural Analgesia - Current Views and Approaches

Fyneface-Ogan¹

2012

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Epidural Analgesia for Perioperative Upper Abdominal Surgery

Siriussawakul¹,

Suwanpratheep²

2012

Epidural Analgesia - Current Views and Approaches

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Complications Associated with Continuous Epidural Analgesia

Cited by 3 publications

References 112 publications

Hypocapnia delays subsequent bupivacaine cardiotoxicity in rats under sevoflurane anesthesia

Hypocapnia delays subsequent bupivacaine cardiotoxicity in rats under sevoflurane anesthesia

Epidural Analgesia - Current Views and Approaches

Epidural Analgesia for Perioperative Upper Abdominal Surgery

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