Epidural test dose: isoproterenol is a reliable marker for intravascular injection in anesthetized adults

Anesthesia and Analgesia
M Tanaka

Abstract

Epidural test doses containing more than 15 micrograms epinephrine are reliable for the detection of intravascular injection based on the conventional systolic blood pressure (SBP) criterion (positive if > or = 15 mm Hg increase) but not on the heart rate (HR) criterion (positive if > or = 20 bpm increase) in adult patients anesthetized with isoflurane. The present study was designed to test whether isoproterenol could be used as a reliable marker. Thirty adult patients were randomly assigned to one of two groups, each of which was anesthetized with 1% end-tidal isoflurane and nitrous oxide after endotracheal intubation. Isoproterenol group (n = 15) was given 3 mL of 1.5% lidocaine with 3 micrograms isoproterenol intravenously (i.v.) to simulate an i.v. administered test dose. The saline group (n = 15) was identical to the isoproterenol group but received 3 mL of normal saline. HR and arterial blood pressure were measured at 20-s intervals for 4 min after i.v. injection. Mean HR in the isoproterenol group was significantly higher than in the saline group from 40 to 240 s after i.v. test dose with a mean maximum HR increase of 32 +/- 7 bpm (mean +/- SD) occurring at 68 +/- 19 s. All 15 patients in the isoproterenol group develop...Continue Reading

References

Aug 1, 1979·Clinical Pharmacology and Therapeutics·R E VestalD G Shand
Mar 1, 1979·Anesthesiology·M Yelderman, A K Ream
Oct 1, 1988·Anesthesiology·C A DeSimoneH Menduke
Jun 1, 1987·Anesthesiology·M P YeagerT Brinck-Johnsen
Nov 1, 1972·British Journal of Pharmacology·M E ConollyM Sandler
Jan 1, 1984·Anesthesiology·G F Marx
Jan 1, 1993·Anesthesia and Analgesia·M PerilloC B Berde
Jan 1, 1993·Journal of Clinical Pharmacology·G ReyesM K Eldadah

❮ Previous
Next ❯

Citations

Jan 29, 2003·Anesthesiology·Friederike B Dietz, Richard A Jaffe

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.