This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (14) Citing Articles via Google Scholar Google Scholar Articles by Sakura, S. Articles by Kosaka, Y. Search for Related Content PubMed PubMed Citation Articles by Sakura, S. Articles by Kosaka, Y.

---

REGIONAL ANESTHESIA AND PAIN MANAGEMENT

Concentration of Lidocaine Affects Intensity of Sensory Block During Lumbar Epidural Anesthesia

Department of AnesthesiologyShimane Medical University, Izumo City, Japan

Address correspondence to Shinichi Sakura, MD, Department of Anesthesiology, Shimane Medical University, 89-1 Enya-cho, Izumo City, 693-8501 Japan. Address e-mail to ssakura{at}shimane-med.ac.jp

We investigated the effects of a twofold difference in concentration and volume of lidocaine on lumbar epidural block using a cutaneous current perception threshold (CPT) quantitative sensory testing device. Twenty ASA I patients scheduled for elective gynecological surgery were randomly divided into two equal groups to receive either 20 mL of 1% lidocaine or 10 mL of 2% lidocaine through an epidural catheter inserted at the L1-2 interspace. CPTs at 2000-, 250-, and 5-Hz stimulation and sensation to light touch, temperature, and pinprick at ipsilateral dermatomes V, T9, and L2 were measured before and every 5 min until 60 min after the epidural lidocaine. Epidural anesthesia with both solutions produced a significant increase in all CPTs at dermatomes T9 and L2. Alterations in CPTs were similar for both groups at T9 but were significantly greater in patients given 2% lidocaine than in those given 1% lidocaine at L2. There were no differences in the upper level of sensory block to cold, pinprick, and touch between the two groups. We conclude that lumbar epidural anesthesia with 10 mL of 2% lidocaine produces more intense blockade of both large- and small-diameter sensory nerve fibers than that with 20 mL of 1% lidocaine.

Implications: The effects of local anesthetic concentration and volume on the quality of epidural anesthesia have not been adequately investigated. The results of the present study suggest that the concentration affects the intensity of sensory block during epidural anesthesia with lidocaine.

This article has been cited by other articles:

				W. A. Visser, R. A. Lee, and M. J. M. Gielen Factors Affecting the Distribution of Neural Blockade by Local Anesthetics in Epidural Anesthesia and a Comparison of Lumbar Versus Thoracic Epidural Anesthesia Anesth. Analg., August 1, 2008; 107(2): 708 - 721. [Abstract] [Full Text] [PDF]

				J. Zhang, W. Zhang, and B. Li The Effect of Epidural Anesthesia with Different Concentrations of Ropivacaine on Sevoflurane Requirements Anesth. Analg., April 1, 2007; 104(4): 984 - 986. [Abstract] [Full Text] [PDF]

				A. Shono, S. Sakura, Y. Saito, K. Doi, and T. Nakatani Comparison of 1% and 2% lidocaine epidural anaesthesia combined with sevoflurane general anaesthesia utilizing a constant bispectral index Br. J. Anaesth., December 1, 2003; 91(6): 825 - 829. [Abstract] [Full Text] [PDF]

				A. Shono, Y. Saito, S. Sakura, K. Doi, and N. Yokokawa Sevoflurane Requirements to Suppress Responses to Transcutaneous Electrical Stimulation During Epidural Anesthesia with 0.5% and 1% Lidocaine Anesth. Analg., October 1, 2003; 97(4): 1168 - 1172. [Abstract] [Full Text] [PDF]

				M. Dernedde, M. Stadler, F. Bardiau, and J. G. Boogaerts Continuous Epidural Infusion of Large Concentration/Small Volume Versus Small Concentration/Large Volume of Levobupivacaine for Postoperative Analgesia Anesth. Analg., March 1, 2003; 96(3): 796 - 801. [Abstract] [Full Text] [PDF]