Back to Search
Start Over
Electrocardiographic and haemodynamic alterations caused by three different test solutions of local anaesthetics to detect accidental intravascular injection in children.
- Source :
-
British journal of anaesthesia [Br J Anaesth] 2012 Feb; Vol. 108 (2), pp. 283-9. Date of Electronic Publication: 2011 Dec 08. - Publication Year :
- 2012
-
Abstract
- Background: The aim of this study was to investigate ECG and haemodynamic alterations provoked by a test dose of bupivacaine, epinephrine, and their combination.<br />Methods: Paediatric patients undergoing general anaesthesia were randomized into three groups. After anaesthesia induction and tracheal intubation, 0.2 ml kg(-1) (max. 3 ml) of the corresponding test solution was i.v. injected: bupivacaine 0.125% (Group B), bupivacaine 0.125% plus epinephrine 1:200 000 (Group BE), or epinephrine 1:200 000 (Group E). ECG was printed and analysed post hoc. Non-invasive arterial pressure (AP) was measured at 1 and 2 min after test dose injection. Increases in T-wave of ≥ 25%, in heart rate (HR) of ≥ 10 beats min(-1), and in systolic AP of ≥ 15 mm Hg above baseline value were considered a positive result.<br />Results: A total of 105 children aged 0.2-16 (median 6.8) yr were enrolled. Test dose injection provoked T-wave elevation in 0%, 85%, and 89% of patients in Groups B, BE, and E, respectively. A positive increase in HR was found in 0%, 68%, and 76%. A positive increase in AP at 1 min was found in 0%, 88%, and 94% and at 2 min in 0%, 42%, and 59%. A decrease in HR of ≥ 10 beats min(-1) was observed in 6%, 76%, and 69%. Alterations in T-wave and HR were significantly influenced by age.<br />Conclusions: ECG and haemodynamic alterations after i.v. injection of a local anaesthetic test dose were significantly influenced by epinephrine. T-wave elevation, increase in AP, and changes in HR are highly reliable variables, particularly when age is taken into account.
- Subjects :
- Adolescent
Age Factors
Anesthesia, General
Anesthetics, Local administration & dosage
Blood Pressure drug effects
Bupivacaine administration & dosage
Bupivacaine pharmacology
Child
Child, Preschool
Drug Combinations
Epinephrine administration & dosage
Epinephrine pharmacology
Female
Heart Rate drug effects
Humans
Infant
Injections, Intravenous
Male
Monitoring, Intraoperative methods
Vasoconstrictor Agents administration & dosage
Vasoconstrictor Agents pharmacology
Anesthetics, Local pharmacology
Electrocardiography drug effects
Hemodynamics drug effects
Medical Errors prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1471-6771
- Volume :
- 108
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- British journal of anaesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 22157845
- Full Text :
- https://doi.org/10.1093/bja/aer389