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Lumbar epidural anaesthesia and sensory profiles in term pregnant patients

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Abstract

Sensory profiles of lumbar epidural anaesthesia were studied in 57 patients during active labour. The local anaesthetics used were chloroprocaine three per cent with and without epinephrine, chloroprocaine two per cent, bupivacaine 0.25 per cent and a mixture of chloroprocaine three per cent and bupivacaine 0.5 per cent.

A common pattern of spread was found for all local anaesthetic solutions with the onset of the block affecting the dermatomes innervated by the thinnest nerve roots (T12L1). There was a percentage of failure to block the thickest nerve root (S1). Inguinal and suprapubic discomfort (“missing segment”) occurred when S1 was not blocked.

Under the conditions of this experiment, the addition of bupivacaine to chloroprocaine did not increase the duration of the blockade significantly.

Résumé

Le profil sensoriel de ľanesthésie épidurale lombaire a été étudié chez 57 parturientes en travail. Les anesthésiques locaux utilisés ont été le chloroprocaïne 3 pour cent avec et sans épinéphrine, la chloroprocaïne 2 pour cent, la bupivacaine 0.25 pour cent et un mélange de chloroprocaïne 3 pour cent et de bupivacaïne 0.5 pour cent.

On a démontré pour routes les solutions ďanesthésiques locaux un schéma commun de propagation du bloquage avec une installation aux dermatomes innervés par les racines les plus fines (T12, L1). On a rencontré une proportion ďéchecs pour la racine la plus épaisse (S1). Une insuffisance de blocage de S1 a été ressentie sous forme de malaise aux régions inguinales et sus-pubiennes.

Lors de cette étude, ľaddition de bupivacaïne à la chloroprocaïne n’a augmenté la durée du blocage de façon significative.

References

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    Galindo, A. &Whitcher, T. Mixture of local anesthetics: bupivacaine-chloroprocaine. Anesthesiology51: S-213 (1979).

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Author information

Correspondence to Teruel de Campo or Maximo Macias-Loza or Harry Cohen or Anibal Galindo.

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Campo, T.d., Macias-Loza, M., Cohen, H. et al. Lumbar epidural anaesthesia and sensory profiles in term pregnant patients. Canad. Anaesth. Soc. J. 27, 274–278 (1980). https://doi.org/10.1007/BF03007439

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Keywords

  • Bupivacaine
  • Nerve Root
  • Local Anaesthetic Solution
  • Procaine
  • Anaesthetic Solution