The Components of an Effective Test Dose Prior to Epidural Block

Moore, Daniel C.; Batra, Manbir S.

doi:10.1097/00000542-198155060-00018

Cited by 225 publications

(17 citation statements)

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“…An intravenous injection of 15 µg of epinephrine typically produces an average heart rate increase of 30 beats per minute between 20 and 40 seconds after its administration. (Moore & Batra, 1981) A survey of academic medical centers in the United States found that 83% of the respondents indicated they use a test dose, whereas 6% do not. (Minzter et al, 2002) …”

Section: Epidural Test Dosementioning

confidence: 99%

Epidural Analgesia for Perioperative Upper Abdominal Surgery

Siriussawakul¹,

Suwanpratheep²

2012

Epidural Analgesia - Current Views and Approaches

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Section: Epidural Test Dosementioning

confidence: 99%

Epidural Analgesia for Perioperative Upper Abdominal Surgery

Siriussawakul¹,

Suwanpratheep²

2012

Epidural Analgesia - Current Views and Approaches

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“…(14) A test dose of 3 mL of solution containing 3 mL of 2% lignocaine with 15 µg of adrenaline in 1:2,00,000 dilutions is given for identification of intravascular or intrathecal placement of epidural needle. (15) After the test dose, Epidural Fentanyl (EF) group receive 20 mL of 0.75% ropivacaine plus 100 µg of fentanyl (2 mL) followed by IV injection of 2 mL of normal saline. The patient in the Intravenous Fentanyl (IF) group receive 20 mL of 0.75% ropivacaine plus 2 mL of normal saline followed by IV injection of 100 µg fentanyl (2 mL).…”

Section: Methodsmentioning

confidence: 99%

Epidural Fentanyl Speeds the Onset of Sensory and Motor Blocks During Epidural Ropivacaine Anaesthesia

A¹,

A²,

Babu³

2016

jemds

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“…Large volumes of local anesthetics injected intravascularly can result in significant toxicity and lead to adverse events such as seizures, coma, respiratory depression, and cardiovascular collapse. Therefore, the conventional epidural test solution, 3 ml of 1.5% lidocaine with 1 : 200,000 epinephrine, helps confirm the correct positioning of epidural catheters by monitoring objective hemodynamic changes [2].…”

Section: Introductionmentioning

confidence: 99%

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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The Components of an Effective Test Dose Prior to Epidural Block

Cited by 225 publications

References 0 publications

Epidural Analgesia for Perioperative Upper Abdominal Surgery

Epidural Analgesia for Perioperative Upper Abdominal Surgery

Epidural Fentanyl Speeds the Onset of Sensory and Motor Blocks During Epidural Ropivacaine Anaesthesia

Changes of the T-wave on range of spinal blockade after low dose epinephrine administration

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