British Journal of Anaesthesia, Vol 81, Issue 5 718-722, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
S. Sakura, M. Sumi, Y. Yamada, Y. Saito and Y. Kosaka
We have examined sensory block during lumbar epidural anaesthesia using a
cutaneous current perception threshold (CPT) sensory testing device in 20
patients who received 10 ml of either 1% or 2% lidocaine (lignocaine). CPT
at 2000, 250 and 5 Hz stimulation at the trigeminal (V), ninth thoracic
(T9) and second lumbar (L2) dermatomes, and dermatomal levels of block to
light touch, temperature and pinprick discrimination were measured before
and every 5 min until 60 min after epidural lidocaine. There were
significant differences between 1% and 2% epidural lidocaine in all CPT at
T9 and L2, in addition to maximal cephalad spread of the three sensory
modalities. After 2% lidocaine, all CPT increased significantly at T9 and
L2. In contrast, only at 250 and 5 Hz for L2 did epidural block with 1%
lidocaine produce significant increases in CPT. Maximal level of loss of
touch sensation after 1% lidocaine was significantly lower than that of
cold and pinprick sensations. We conclude that the dose of lidocaine
affected intensity of sensory block during lumbar epidural anaesthesia. In
addition, differential neural block resulting from epidural anaesthesia
appeared to be associated with a differential effect on nerve fibres of
different sizes.
CLINICAL INVESTIGATIONS
Quantitative and selective assessment of sensory block during lumbar epidural anaesthesia with 1% or 2% lidocaine
Department of Anaesthesiology, Shimane Medical University, 89-1 Enya-cho, Izumo City, 693-8501 Japan
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