Epidural block for obstetrics: comparison of bolus injection of local anesthetic with gravity flow technique

Journal of Clinical Anesthesia
S Cohen, D Amar

Abstract

To test the hypothesis that slow administration of local anesthetic into the epidural space by gravity flow reduces the incidence of signs and symptoms of unintended injection. Prospective, randomized study. Teaching hospital. 600 ASA physical status l and II parturients scheduled for labor and delivery or elective cesarean section. After identification of the epidural space with pulsations of an air-fluid column, parturients for vaginal delivery (n = 380) were randomized to receive a test dose of 3 ml 3% 2-chloroprocaine with epinephrine 20 micrograms, two doses of 7 ml bupivacaine 0.03% with sufentanil 1 microgram/ml and epinephrine 2 micrograms/ml by either gravity flow (Group 1) given over 30 seconds or by bolus injection (Group 2) given over 5 seconds through the epidural needle; parturients for Cesarean delivery (n = 220) were randomized to receive a test dose and two doses of 6 ml lidocaine 2% with sufentanil 1 microgram/ml and epinephrine 2 micrograms/ml by either gravity flow or by bolus injection through the epidural needle. Changes in maternal heart rate (HR) and blood pressure, signs of intravascular injection, and adverse effects of epidural bupivacaine-sufentanil were recorded after each dose. Gravity flow adminis...Continue Reading

References

Oct 1, 1991·Acta Anaesthesiologica Scandinavica·S CohenH Nagashima
Mar 1, 1989·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·C T CrochetièreJ J Coté
Aug 1, 1988·British Journal of Anaesthesia·D B Scott
Feb 1, 1987·Anaesthesia·R B GriffithsD Blake
Jul 1, 1967·Anesthesia and Analgesia·J E UsubiagaL E Usubiaga
May 1, 1967·Anesthesiology·P R Bromage
Aug 1, 1966·British Journal of Anaesthesia·D P Braid, D B Scott
Oct 1, 1982·Anesthesiology·K Mustafa, R A Milliken
Feb 1, 1981·Anesthesiology·N B Kenepp, B B Gutsche
May 1, 1962·Canadian Anaesthetists' Society Journal·G F MARXL R ORKIN

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Citations

Jun 6, 2015·Acta Anaesthesiologica Scandinavica·J T DennyC W Hunter-Fratzola
Jul 18, 2008·Anesthesia and Analgesia·Shaul Cohen, Maria Negron
Nov 11, 2020·Regional Anesthesia and Pain Medicine·Aki Uemura

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