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Abstracts and Programme: European Society of Anaesthesiologists; 9th Annual Meeting with the Swedish Society of Anaesthesiology; Gothenburg, Sweden, 7-10 April 2001: Local and Regional Anaesthesia

Epidural infusion of saline to revert epidural anaesthesia

Rodríguez, J.; Rodríguez, V.; Naveira, A.; Bárcena, M.; Álvarez, J.

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European Journal of Anaesthesiology (EJA): 2001 - Volume 18 - Issue - p 82
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Abstract A-289

Background and goals of the study: Duration of neuraxial blocks can outlast duration of surgery. Infusion of saline into the epidural space after surgery has been proposed as a mean to accelerate recovery after epidural anaesthesia (EA) [1-3]. We studied if the infusion of a higher volume of saline can provide a faster recovery.

Materials and methods: Prospective, randomized, controlled double blind study. Thirty patients were randomly assigned to control group, to group 2× (epidural infusion with twice the volume of 2% mepivacaine given to reach a sensory level of T4-T6) and group 4× (epidural infusion with four times the volume of 2% mepivacaine). Recovery was assessed with TOF stimulation at T10 and L2 for sensory blockade and with a modified Bromage's scale for motor blockade. Mepivacaine plasma levels were studied. Kruskal-Wallis nonparametric test, one-way ANOVA followed by Bonferroni's test and Student's t-test for paired data followed by Bonferroni's correction and colleagues were used when appropriate.

Results and discussion: Groups were similar for weight, age and dose of mepivacaine. A significant decrease in the duration of sensory blockade in groups 2× and 4× was found when compared with control group. No difference was found between infusion groups. TABLE

Table 1
Table 1:
Recovery from motor and sensory block (mean ± SD)

One patient in group 4× presented transient symptoms of intracranial hypertension. Mepivacaine plasma levels increased significantly in group 4× after saline infusion.

Conclusion: Saline infusion seems to have a maximum effective dose in shortening duration of EA. High volumes of saline increase systemic uptake of the local anaesthetic and can produce intracranial hypertension.

References:

1 Brook Utne JG, Macario A, Dillingham MF et al. Reg Anesth Pain Med 1998; 23: 247-51.
2 Johnson MD, Burger GA, Mushlin PS et al. Anesth Analg 1990; 70: 395-9.
3 Chan VWS, Nazarnia S, Kaszas Z et al. Anesth Analg 1999; 89: 1006-10.

Section Description

The abstracts published in this supplement have been typeset from camera-ready copies prepared by the authors. Every effort has been made to reproduce faithfully the abstracts as submitted. These abstracts have been prepared in accordance with the requirements of the European Society of Anaesthesiologists and have not been subjected to review nor editing by the European Journal Of Anaesthesiology. However, no responsibility is assumed by the organisers for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of methods, products, instructions or ideas contained in the material herein. Because of the rapid advances in medical sciences, we recommend that independent verification of diagnoses and drug doses should be made.

© 2001 European Society of Anaesthesiology