Venoconstrictor Agents Mobilize Blood from Different Sources and Increase Intrathoracic Filling during Epidural Anesthesia in Supine Humans

Stanton‐Hicks, Michael; Höck, A.; Stühmeier, Klaus-Dieter; Arndt, J. O.

doi:10.1097/00000542-198703000-00009

Cited by 21 publications

(6 citation statements)

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“…The blood volume shift to the legs could be reversed with dihydroergotamine, a α 1 -agonist which preferentially constricts capacitance vessels of skeletal muscle and skin and thus reverses the pooling effect. Etilephrine, a mixed αand β-agonist, selectively constricts the splanchnic vasculature and thus reverses the splanchnic pooling effects of epidural anaesthesia 49 .…”

Section: Mid Thoracic-lumbar Epidural Anaesthesia (T5-s5)mentioning

confidence: 99%

Cardiovascular and Pulmonary Effects of Epidural Anaesthesia

Veering

Cousins

2000

Anaesth Intensive Care

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Epidural anaesthesia has been used since the early 1900s. Consequently the general characteristics of these procedures have been well defined. More studies have provided a better understanding of the cardiopulmonary changes produced by epidural anaesthesia. The cardiovascular effects observed with epidural anaesthesia are complex and variable, depending on a multitude of factors. The extent of sympathetic denervation, balance of sympathetic and parasympathetic activity, the pharmacological effect of systemically absorbed local anaesthetic agents, inclusion of adrenaline in the anaesthetic solution, the distribution of blood in relation to cardiac filling and cardiovascular function of the patient must be taken into account when considering the circulatory effects of epidural anaesthesia. Individual cardiovascular response to different levels of sympathetic blockade varies widely, depending on the degree of sympathetic tone before the block. Epidural anaesthesia that is restricted to the level of the low thoracic and lumbar region (T5-L4) results in a "peripheral" sympathetic blockade with vascular dilatation in the pelvis and lower limbs. High thoracic epidural anaesthesia, from the first to fifth thoracic, blocks the cardiac afferent and efferent sympathetic fibres with loss of chronotropic and inotropic drive to the myocardium. Thoracic epidural anaesthesia appears to at least partly reverse the diaphragmatic dysfunction that is a major determinant of the decrease in lung volumes observed after upper abdominal surgery. This article summarizes cardiovascular and pulmonary responses to epidural anaesthesia. Details of clinical management are not included in the review.

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Section: Mid Thoracic-lumbar Epidural Anaesthesia (T5-s5)mentioning

confidence: 99%

Cardiovascular and Pulmonary Effects of Epidural Anaesthesia

Veering

Cousins

2000

Anaesth Intensive Care

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“…Etilefrine is a sympathomimetic drug with mixed alpha‐ and beta‐agonist activity similar to ephedrine[8,12–13]. It is widely used in central Europe and Scandinavia to restore normal blood pressure during spinal anaesthesia[7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Ephedrine is a well‐established sympathomimetic drug, used for the prevention of hypotension[5–6]. In Scandinavia and central Europe, etilefrine is used during anaesthesia for much the same purpose as ephedrine[7,8]. In Morocco, only etilefrine is available[9].…”

Section: Introductionmentioning

confidence: 99%

The effect of oral etilefrine premedication on the incidence of hypotension during spinal anaesthesia

et al. 2000

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This study was designed to determine the efficacy of oral etilefrine in preventing hypotension induced by spinal anaesthesia. Forty patients, ASA grade I or II, aged 23-60 years, scheduled for orthopaedic surgery involving the lower extremity under spinal anaesthesia were studied. The patients were randomly allocated to one of two groups; the etilefrine group (n = 20) received oral etilefrine 15 mg (30 drops), 60 min before the subarachnoid block, and the control group (n = 20) received no etilefrine. Patients were given 0.5% isobaric bupivacaine intrathecally. Hypotension was defined as a 30% decrease from base-line for systolic arterial pressure and mean arterial pressure or systolic value <90 mmHg, and was treated with intravenous boluses of etilefrine 2 mg. The overall incidence of spinal anaesthesia induced hypotension was 25%, ranging from 20% in the etilefrine group to 30% in the control group. The fall in systolic arterial pressure and mean arterial pressure was significantly greater in the control group than in the etilefrine group (P < 0.05). The patients in the etilefrine group received less etilefrine supplement than those in control group and no subject in the etilefrine group required repeat etilefrine doses, while in the control group five patients received multiple etilefrine doses (P < 0.05). The mean heart rate remained fairly stable throughout the study periods. We conclude that oral etilefrine, given 60 min before surgery, reduces the fall in blood pressure during spinal anaesthesia.

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“…Etilefrine is a sympathomimetic drug with mixed alpha-and beta-agonist activity similar to ephedrine [8,12,13]. It is widely used in central Europe and Scandinavia to restore normal blood pressure during spinal anaesthesia [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Keywords: ETILEFRINE, hypotension, spinal anaesthesia. same purpose as ephedrine [7,8]. In Morocco, only etilefrine is available [9].…”

Section: Introductionmentioning

confidence: 99%

The effect of oral etilefrine premedication on the incidence of hypotension during spinal anaesthesia

Bouaggad¹,

Harrar²,

Bouderka³

et al. 2000

European Journal of Anaesthesiology

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Venoconstrictor Agents Mobilize Blood from Different Sources and Increase Intrathoracic Filling during Epidural Anesthesia in Supine Humans

Cited by 21 publications

References 0 publications

Cardiovascular and Pulmonary Effects of Epidural Anaesthesia

Cardiovascular and Pulmonary Effects of Epidural Anaesthesia

The effect of oral etilefrine premedication on the incidence of hypotension during spinal anaesthesia

The effect of oral etilefrine premedication on the incidence of hypotension during spinal anaesthesia

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