Canadian Journal of Anaesthesia

, Volume 37, Issue 8, pp 867–872

Epidural anaesthesia attenuates the catecholamine response to hypoventilation

  • Rom A. Stevens
  • Paul J. Lineberry
  • Thomas J. Arcario
  • Glenn S. Bacon
  • Larry W. Cress
Reports of Investigation

Abstract

The effect of a high epidural block on the catecholamine response to hypoventilation was studied in six unanaesthetized dogs given intravenous sufentanil (15 μg · kg−1). Sufentanil alone resulted in a increase of norepinephrine (NE) concentration from 108 ± 73 pg · ml−1 to 843 ± 399 pg· ml−1 and epinephrine (E) from 279 ± 80 pg· ml−1 to 2010 ± 1416 pg · ml−1. At least one week later, an epidural block to Tl was achieved using 8–10 ml, two per cent lidocaine. Plasma NE and E decreased after EA to about 50 per cent of resting baseline measurements. The addition of sufentanil increased NE and E levels to reach approximately the resting baseline levels. In all dogs intravenous sufentanil resulted in bradypnoea, bradycardia, hypoxaemia, and hypercarbia. Intravenous lidocaine infusions had no significant effect on plasma catecholamine levels when plasma lidocaine levels ranged from 1.7 μg· ml−1 to 5.3 μg·ml−1. We conclude that a high two per cent lidocaine epidural block attenuates the catecholamine response to hypoventilation in dogs, but the persistence of baseline plasma levels of NE and E suggests that the efferent sympathetic block by high EA is incomplete.

L’effet d’un bloc épidural haut sur la réponse des catécholamines à l’hypoventilation a été étudié sur six chiens non anesthésiés ayant reçu du sufentanil intraveineux (15 μg · kg−1). Le sufentanil seul a amené une augmentation de la norépinephrine (NE) de 108 ± 73 pg·ml−1à 843 ± 399 pg·ml−1 et des concentrations d’épinéphrine (E) de 279 ± 80 pg · ml−1 2010 ± 1416 pg·ml−1. Au moins une semaine plus tard, un bloc epidural a été acquis utilisant 8 à 10 ml de deux pour cent de lidocaine. Les concentrations plasmatiques de NE et de E out diminuees apres EA d’après pen près 50 pour cent des mesures de base. L’addition de sufentanil augmentant les niveaux de NE et de E pour atteindre approxirnativemenl les niveaux de base. Sur tous les chiens, le sufentanil intraveineux a amene une bradypnée, une bradycardie, une hypoxymie et une hypercarbie. Les infusions de lidocaine intraveineuses n’avaient aucun effet significatif sur les niveaux de catecholamine plasmatique quand le taux de lidocaine plasmatique s’éténdait de 1.7 μg·ml−1 a 5.3 μg · ml−1. On conclut qu’un bloc épidural haut avec deux pour cent de lidocaine atténue la réponse du catecholamine à l’hypoventilation chez les chiens et la persistance des niveaux plasmatiques de contrôle de NE et de E suggère que le bloc sympathique efferent par un EA haut est incomplet.

Key words

Anaesthetic Techniques: epidural Anaesthetics, Local: lidocaine Anaesthetics Intravenous: sufentanil Sympathetic Nervous System: blockade, epinephrine, norepinephrine 

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Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Rom A. Stevens
    • 1
  • Paul J. Lineberry
    • 1
  • Thomas J. Arcario
    • 1
  • Glenn S. Bacon
    • 1
  • Larry W. Cress
    • 1
  1. 1.Department of AnesthesiologyUniformed Services University of the Health Sciences and the National Naval Medical CenterBethesdaUSA

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