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British Journal of Anaesthesia, 1988, Vol. 60, No. 6 645-650
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

INFLUENCE OF DEXTRAN ON THE ABSORPTION OF ADRENALINE-CONTAINING LIGNOCAINE SOLUTIONS: A PROTECTIVE MECHANISM IN LOCAL ANAESTHESIA

H.-A. ADAMS, J. BISCOPING, H. KAFURKE, H. MÜLLER, B. HOFFMANN, U. BOERNER and G. HEMPELMANN

HANS-ANTON ADAMS, M.D.; JÜRGEN BISCOPING, M.D.; HART-MUTH KAFURKE; HERMANN MÜLLER, M.D.; BEATE HOFFMANN; ULF BOERNER, M.D.; GUNTER HEMPELMANN, M.D.; Abteilung fur Anaesthesiologie und Operative Intensivmedizin, Klin-ikum der Justus-Liebig-Universitat Gießen, Klinikstr. 29, D-6300 Gießen, Federal Republic of Germany.

The effect of adding 6% dextran to a lignocaine solution containing adrenaline was studied in 27 neurosurgicalpatients during modified neurolept-anaesthesia. Before trepanation they received infiltration anaesthesia of the scalp at the site of the proposed operation. For a period of 1 h following injection plasma concentrations of adrenaline were measured by high pressure liquid chromatography and serum concentrations of lignocaine by gas chromatography. The addition of dextran caused a significant reduction in the absorption of both adrenaline and lignocaine from the injection site. It is concluded that the dextran adjuvant constitutes a protective mechanism against toxic systemic side effects in local anaesthesia using adrenaline-containing anaesthetic solutions. This effect is particularly significant in patients with pre-existing cardiovascular disease and when local anaesthetic solutions are used in combination with volatile anaesthetics.


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