| The Comparative Investigation of the Spread of Epidural Anesthesia . |
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Ki Ryang Ahn, Kyo Sang Kim, In Kyu Kim, Heung Dae Kim, Young Suck Kim, Wan Sik Kim |
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Department of Anesthesiology, Hanyang University College of Medicine, Seoul, Korea. |
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| Abstract |
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Epidural anesthesia is widely practiced for lower abdominal operation and delivery in many hospital and its complication in minimal compared with spinal anesthesia. Lidocaine has been used extensively for epidural anesthesia with very satisfactory results. It has a very rapid onset of action, producing complete analgesia and has a reasonable duration of action(about 1-1(1/2)hr). A concentration of 1. 5% lidocaine causes effective sensory and autonomic blockade but it is unlikely to produce motor paralysis. More recently, bupivacaine(0.5%) has tended to supplement lidocaine as the drug of choice of epidural anesthesia.
Firstly, the duration of action is longer. Secondly, it has better affinity for the tissue so that less will be absorbed into the circulation, thus reducing the risk of a toxic reaction. Thirdly, when used with a continuous technique, there is much chance of tachyphylaxis. Using a standardized anesthesia technic, we compared level of sensory anesthesia with a 0. 5% bupivacaine and 1. 5% lidocaine under elective and emergency surgery. When equal volume of local anesthetic solution were injected(20 ml of 0.5% bupivacaine and l. 5% lidocaine) there were no statistically significant differences in sensory level in bupivacaine and lidocaine, but the duration of anesthesia in bupivacaine from 2 to 3 times longer than lidocaine. |
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