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

Lee, Jeong Woo; Kim, Deokyu; Choi, Hyun Ho; Kim, Dong Chan

doi:10.4097/kjae.2010.58.4.351

Cited by 2 publications

(2 citation statements)

References 21 publications

(16 reference statements)

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“…Lee et al [8] also reported similar results in spinal anesthetic patients. These studies suggest that monitoring T wave changes may constitute an approach for the detection of unintentional intravenous (IV) administration of epinephrinecontaining solution.…”

Section: Introductionmentioning

confidence: 53%

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: Introductionmentioning

confidence: 53%

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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“…According to Knoll-Köhler et al [ 43 ], the injection of 20 μ g epinephrine produced a doubling of plasma epinephrine levels and an increase of HR of about 4 bpm after 5 min, which is all near to our measured values. Theoretically, an indirect mechanism of ß -receptor stimulation may be a decrease in plasma potassium values [ 50 ]. Low plasma potassium may cause T -wave flattening or inversion [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular and Vector‐Cardiographic Effects of Articaine Anesthesia with Epinephrine

Pökel,

Schulze,

Busse

2024

International Journal of Dentistry

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The aim was to investigate the vector‐cardiographic effects in patients submitted to dental extraction under local anesthesia. Twenty‐one patients aged 36.6 ± 12.4 years with a clinical and radiographic indication of mandibular or maxillary tooth extraction were enrolled. The intervention was a local or mandibular nerve block anesthesia with 4% articaine hydrochloride containing epinephrine (1 : 100,000; 40 mg/ml + 10 μg/ml). Blood pressure (BP), heart rate (HR), pulse wave transit time, and vector‐cardiography data were recorded throughout 3 min before and 5 min after injection. QRS‐ and T‐wave area under the curve (QRSAUC/TAUC) were calculated from the X/Y/Z QRS‐vector or T‐vector. T‐wave amplitude (TAM), TAUC values, and diastolic BP decreased, and HR significantly increased 4 min after injection. A transient moderate HR drop and a corresponding small increase in TAM and TAUC immediately after the injection procedure may be explained by a decreased sympathetic tone due to psychological relief. In dental anesthesia, the systemic epinephrine effects are represented by a decrease in TAUC. These effects are most pronounced in the X‐ and Y‐leads. The 3D determination of vector planes or amplitudes is a simple method to register the sympathetic tone in local anesthesia independently of possible effects on T‐wave characteristics in single leads. In conclusion, T‐wave determination may help to detect even small increases in systemic adrenaline concentration in case of accidental intravascular injection. At the same time, full rhythm and spatial ischemia control is provided.

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

Cited by 2 publications

References 21 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

Cardiovascular and Vector‐Cardiographic Effects of Articaine Anesthesia with Epinephrine

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