Reversal of Lidocaine with Epinephrine Epidural Anesthesia Using Epidural Saline Washout

Sitzman, Todd B.; DiFazio, Cosmo A.; Playfair, Paul A.; Stevens, Rosemary; Hanes, Chad F.; Herman, Todd B.; Yates, Kendall H.; Leisure, George S.

doi:10.1097/00115550-200105000-00008

Cited by 13 publications

(2 citation statements)

References 15 publications

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“…Partial and total motor and sensory recovery times were significantly faster in the epidural lavage solution groups than in the control group. In addition, recovery was faster in subjects who received 2 boluses [5].…”

Section: Discussionmentioning

confidence: 88%

Lipid Emulsion for Spinal Anaesthesia Reversal - A Therapeutic Option

Mohamed,

Dalila,

et al. 2023

Recent Adv Clin Trials

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High spinal anaesthesia is also one of the commonly faced problems, with a low incidence of a complete spinal block; which is one of the life-threatening complications unless immediately identified and treated. Up to now, its management has relied mainly on intensive means such as respiratory and circulatory assistance. Intravenous lipid emulsions have an established position in the management of local anesthetic toxicity. After the success in this area, ILE has been used under clinical conditions for various kinds of overdose. At present, ILEs are expanding into a new field, that of reversing the effects of local anesthesia on peripheral nerves and neuraxial anesthesia. We report two cases of patients operated at our department, the first for genital prolapse under perimedullary anaesthesia, complicated by high spinal anaesthesia. The second case was a patient who underwent Caesarean section under spinal anaesthesia, intubated mid-operatively and presented with postoperative delayed awakening. Both complications were resolved by intralipid injection. We then reviewed the literature concerning similar cases and the different means used to resolve the problem.

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Section: Discussionmentioning

confidence: 88%

Lipid Emulsion for Spinal Anaesthesia Reversal - A Therapeutic Option

Mohamed,

Dalila,

et al. 2023

Recent Adv Clin Trials

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“…Surprisingly, this includes patients undergoing fusions, with the significant muscle dissection and manipulation needed there, and even to endoscopic epidural procedures, where constant flow of irrigation threatens to wash away all anesthetic from the epidural space. [24][25][26][27] In cases of revision surgery where there are significant epidural adhesions inhibiting the spread of anesthetic adequately, adding new analgesic method such as thoracolumbar interfascial plane block (TLIP), modified TLIP and Erector spinae plane block (ESP) 28-30 together with epidural anesthesia will give us more complete and satisfied results of anesthesia and analgesia.…”

Section: Figurementioning

confidence: 99%

<p>Advantages of the Combination of Conscious Sedation Epidural Anesthesia Under Fluoroscopy Guidance in Lumbar Spine Surgery</p>

Kang¹,

Kashlan²,

Singh³

et al. 2020

JPR

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Background: With the increase in life expectancy seen throughout the world, the prevalence of degenerative spinal pathology and surgery to treat it has increased. Spinal surgery under general anesthesia leads to various problems and complications, especially in patients with numerous medical comorbidities or elderly patients. For this reason, there is a need for safer anesthetic methods applicable to unhealthy, elderly patients undergoing spinal surgery. Purpose: To report our experience with utilizing fluoroscopy-guided epidural anesthesia in conjunction with conscious sedation in spinal surgery. Patients and Methods: We performed a retrospective review of 111 patients at our institution that received fluoroscopy-guided epidural anesthesia for lumbar surgery from February to September 2018. Patients' records were evaluated to evaluate patient demographics, American Society of Anesthesiology Physical Classification System (ASA) class, and pain numerical rating scores (NRS) preoperatively and throughout their recovery postoperatively. Intraoperative data including volume of epidural anesthetic used, extent of epidural spread, and inadvertent subdural injection was collected. Postoperative recovery time was also collected. Results: The mean age of our patients was 60 years old with a range between 31 and 83 years old. All patients experienced decreases in postoperative pain with no significant differences based on age or ASA class. There was no association between ASA class and time to recovery postoperatively. Older patients (age 70 years or greater) had a significantly longer recovery time when compared to younger patients. Recovery also was longer for patients who received higher volumes of epidural anesthesia. For every 1 mL increase of epidural anesthetic given, there was an increase in the extent of spread of 1.8 spinal levels. Conclusion: We demonstrate the safety and feasibility of utilizing conscious sedation in conjunction with fluoroscopy-guided epidural anesthesia in the lumbar spinal surgery.

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Case 32: Shortening Postanesthesia Recovery Time After an Epidural. Is It Possible?

Brock‐Utne

2017

Clinical Anesthesia

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Reversal of Lidocaine with Epinephrine Epidural Anesthesia Using Epidural Saline Washout

Cited by 13 publications

References 15 publications

Lipid Emulsion for Spinal Anaesthesia Reversal - A Therapeutic Option

Lipid Emulsion for Spinal Anaesthesia Reversal - A Therapeutic Option

<p>Advantages of the Combination of Conscious Sedation Epidural Anesthesia Under Fluoroscopy Guidance in Lumbar Spine Surgery</p>

Case 32: Shortening Postanesthesia Recovery Time After an Epidural. Is It Possible?

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