The Hemodynamic Responses to an Intravenous Test Dose in Vascular Surgical Patients

Schoenwald, Peter K.; Whalley, David G.; Schluchter, Mark D.; Gottlieb, Alexandru; Ryckman, Joseph V.; Bedocs, Nita Marie

doi:10.1213/00000539-199505000-00002

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Perillo et al 2 also used the same criteria for a positive test response in children anaesthetized with halothane. In adults the criteria used have been quite variable ranging from increases of 8 bpm to 20 bpm above baseline [4][5][6][7][8] . To obviate the effect of pain and stress on haemodynamic parameters, intravenous access was established after induction of general anaesthesia and all the observations were completed before intubation and surgical incision.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Isoprenaline with Adrenaline as Components of Epidural Test Dose Solutions for Halothane Anaesthetized Children

Tyagi

Sethi

Chatterji

2002

Anaesth Intensive Care

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In this randomized controlled trial we studied the haemodynamic effects of intravenous injection of lignocaine 1 mg/kg with either no additive, isoprenaline 0.05 µg or 0.075 µg/kg, or adrenaline 0.5 µg/kg in children anaesthetized with halothane. An increase of 10 bpm in heart rate or 20% rise in blood pressure was taken as a positive test response. Adrenaline was confirmed to be an unreliable marker with a positive test in only 67% of cases. For both doses of isoprenaline, the heart rate changes produced a positive test in 100% of cases. There was no statistically significant difference between the two doses of isoprenaline in regard to mean maximum increase in heart rate, mean time of beginning, ending or duration of positive test response and mean time to reach peak heart rate. The positive test response began between 10 and 50 seconds and lasted for an average of 69±54 seconds with the lower dose of isoprenaline 0.05 µg/kg. No advantage could be seen with the higher dose of isoprenaline. Change in blood pressure was not a useful criterion to detect intravascular injection. Recommendations for the use of isoprenaline as a marker of intravascular injection during regional blockade must be deferred until the safety of this agent's effect on neurological tissue is confirmed.

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Section: Discussionmentioning

confidence: 99%

Comparison of Isoprenaline with Adrenaline as Components of Epidural Test Dose Solutions for Halothane Anaesthetized Children

Tyagi

Sethi

Chatterji

2002

Anaesth Intensive Care

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“…No specific anaesthetic agents are contraindicated in von Hippel-Lindau disease, and so anaesthetic management should be tailored according to any relevant findings (such as phaeochromocytoma or intracranial lesions) [6]. We used epinephrine as a component of the epidural test dose in this normotensive patient because in our and others' experience any inadvertent intravascular injection of epinephrine 15 mg is likely to cause an increase in mean arterial pressure of only about 15-20 mmHg, and the drug mainly affects the heart rate [13][14][15]. The consequences of systemic lidocaine injection would have more detrimental effects both for the baby and the mother.…”

Section: Discussionmentioning

confidence: 99%

Epidural anaesthesia for Caesarean section in a patient with von Hippel-Lindau disease

et al. 2001

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Von Hippel-Lindau disease is a rare autosomal dominant disease with incomplete penetrance and variable expression and is characterized by diffuse haemangioblastomas of the central nervous system and viscera. The majority of the central nervous system lesions are located in the cerebellum. This report describes the successful management with epidural anaesthesia of a woman with a term gestation, von Hippel-Lindau disease and cerebellar haemangioblastoma.

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“…58 Several studies suggest that blood pressure change is more sensitive for indicating intravascular injection of epinephrine than is heart rate change, 51,56 particularly for patients receiving opiates. 55 Similarly, elderly patients are less responsive to beta stimulation, 59 as are those taking beta-blocking drugs. In these patients, the clinician should be more focused on detecting changes in blood pressure and T-wave morphology after the test dose.…”

mentioning

confidence: 99%

Current concepts in resuscitation of patients with local anesthetic cardiac toxicity

Weinberg

2002

Regional Anesthesia and Pain Medicine

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The Hemodynamic Responses to an Intravenous Test Dose in Vascular Surgical Patients

Cited by 3 publications

References 10 publications

Comparison of Isoprenaline with Adrenaline as Components of Epidural Test Dose Solutions for Halothane Anaesthetized Children

Comparison of Isoprenaline with Adrenaline as Components of Epidural Test Dose Solutions for Halothane Anaesthetized Children

Epidural anaesthesia for Caesarean section in a patient with von Hippel-Lindau disease

Current concepts in resuscitation of patients with local anesthetic cardiac toxicity

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