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British Journal of Anaesthesia, 1986, Vol. 58, No. 10 1135-1140
© 1986 The Board of Management and Trustees of the British Journal of Anaesthesia

other

INFLUENCE OF EXTRADURAL BLOCKADE AND EPHEDRINE ON TRANSCUTANEOUS OXYGEN TENSION

J. A. ODOOM, M.D, I.L. SIH, M.D, J. G. BOVILL, M.D. F. F.A.R.C.S.I*, B. VAN DER BROEK and J. OOSTING, PH.D.

Department of Anaesthesia Department of Medical Physics University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

Correspondence to J.A. Odoom.

The influence of lumbar extradural blockade with 0.5% plain bupivacaine on transcutaneous oxygen tension (PtcO2) and skin temperature was studied in 20 patients, 10 scheduled for vascular surgery and 10 for urological surgery. At the time of maximum extent of blockade, mean arterial pressure {MAP) had decreased significantly (P < 0.001) from 96.6± 18.8mm Hg to 69.5±10.1 (mean±SD) in the vascular group and from 88.0± 14.7mm Hg to 71.1 ± 12 mm Hg in the uroiogicai group. In the vascular group PtcO2 decreased significantly in the ischaemic (P < 0.07) and non-ischaemic (P < 0.001) limbs. In the uroiogicai group, there was a significant (P < 0.001) decrease in PtcO2 in both limbs. There was no change in cutaneous temperature in the ischaemic limbs (vascular group), but the temperature in the non-ischaemic limbs increased significantly (P < 0.01). In the uroiogicai group, the cutaneous temperature increased significantly (P< 0.001) in both limbs. When ephedrine 10mg was administered i.v., MAP increased significantly (P < 0.001) in both groups to pre-blockade values. This was accompanied in both groups by significant increases in PtcO2, but not by a change in skin temperature. There was a significant correlation between change in MAP and change in PtcO2 in both groups after ephedrine.

*Present address: Department of Anaesthesia, University Hospital, University of Leiden, Rijnsburgerweg 10, 2333 AA Leiden, the Netherlands.


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