Effectiveness of epinephrine with intrathecal Lidocaine for spinal anesthesia on onset time of sensory block and total analgesia consumption at ALERT referral hospital, Addis Abeba Ethiopia,2019.
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Date
2019-12
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Addis Abeba University
Abstract
Introduction: Spinal anesthesia is one of the most popular and widely used anesthetic
procedures. Different techniques used widely to fasten the onset and to prolong the duration and
increase the quality of analgesia of Neuraxial block. Currently epinephrine appears promising in
influencing onset and duration of local anesthesia.
of 0.2mg of Epinephrine to 5% Lidocaine is effective both to shorten onset of the block and
prolong duration of analgesia with additional incentives of decrease total analgesia consumption.
Objective: to assess Effectiveness of epinephrine with intrathecal Lidocaine for spinal
anesthesia on onset time of sensory block and total analgesia consumption at ALERT referral
hospital
Methodology: a hospital based cohort study was conducted at ALERT hospital from October 14Novembr
15, 2019 on 44 ASA class I and II patients whose age above 18 undergoing elective
lower abdominal surgery by using systematic random sampling method. Onset of the block,
duration of analgesia, analgesia requestand total analgesia consumption were assessed.
Distribution of numerical data analyzed using Shapiro Wilk test then after Mann Whitney U test
were used to compare asymmetric data. Independent t-test was used to compare mean values of
symmetric data. Categorical variable between two groups were analyzed using Chi Square. p
value of <0.05 considered as significant.
Results:The onsets of complete sensory blockade were significantly shorter in patients in
Epinephrine group with Mean±SD of 8.91±2.46 and Lidocaine alone group 14.05±4.1 with
(p=0.024). There was also statistically significant difference on the duration of sensory block in
EpinephrinegroupMean± SD of 149.09 ±16.01 and Lidocainealone group 158.68 ± 28.70 with p
=0.001. The first analgesia requesting time were significantly longer in EpinephrineGroup than
Lidocaine alone(p 0.026.)and total analgesia consumption also shows is statistically significant
difference between Epinephrine75(50 ±200 and Lidocainealone 150 (200±150)with p
=0.001.Post-operative pain score were also significantly lower at 12 and 24 hour in Epinephrine
groupwith p value 0.022and 0.041.
Conclusion and recommendations:- Addition of 0.2mg of Epinephrine to 5% Lidocaine
solution in spinal anesthesia for lower abdominal surgeries resulted in rapid onset of sensory
blockade and prolongs the duration of sensory blockade and analgesic request time ,it also
decrease total analgesia consumption with no significant side effects, so we recommend addition
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Keywords
Spinal anesthesia,epinephrine, intrathecal Lidocaine