Journal of Clinical Monitoring

, Volume 7, Issue 3, pp 213–216

Epinephrine-containing test dose during beta-blockade

  • Ken Mackie
  • Arthur Lam
Original Articles

DOI: 10.1007/BF01619262

Cite this article as:
Mackie, K. & Lam, A. J Clin Monitor Comput (1991) 7: 213. doi:10.1007/BF01619262


Epinephrine is routinely used as a marker for intravascular injection during administration of regional anesthesia. The cardiovascular response of patients on beta-blockers to such a test dose has been reported to be unpredictable. We investigated this interaction by administering 15 µg of epinephrine intravenously to 6 healthy volunteers 39 to 48 years old before and after beta-blockade, accomplished by intravenous injection of propranolol, 0.04 mg/kg. Epinephrine administration caused a 20 ± 4% (mean ± SEM) increase in heart rate before beta-blockade but a 38 ± 3% reduction after beta-blockade. The lowest heart rate recorded was 28 beats/min. We conclude that, in middle-aged beta-blocked men, intravenous injection of a standard epinephrine-containing test dose will predictably cause significant hypertension followed by marked bradycardia.

Key words

Anesthesia techniques, regionalSympathetic nervous system: beta-adrenergic blockadeHeart: rate

Copyright information

© Little, Brown and Company 1991

Authors and Affiliations

  • Ken Mackie
    • 1
  • Arthur Lam
    • 1
  1. 1.Department of Anesthesiology, Harborview Medical CenterUniversity of Washington School of MedicineSeattle