بررسی مقایسه ای تاثیر لیدوکائین- سالین، لیدوکائین- فنتانیل و لیدوکائین- اپی نفرین از نظر طول مدت بلوک حسی وحرکتی در بی حسی اپی دورال

Background and purpose: Lidocaine is an intermediate acting local anesthetic agents used very much in epidural anesthesia and has less risk of cardiac or CNS problems compared with bupivacaine. This study evaluated the duration of motor and sensory block of epidural anesthesia with lidocaine alone, lidocoine plus epinephrine and lidocaine plus fentanyl. Materials and Methods: In this double blind study 60 ASA I and II patients that scheduled for elective orthopedic operation were classified by block randomization in to three groups. Epidural anesthesia had been prescribed with 380 mg 2% lidocaine plus 1ml normal saline 0.9% for group N, 380 mg 2% Lidocaine plus 100 m/g (1ml from 1/10000 solution) for group E and 380 mg 2% lidocaine plus 500 m/g fentanyl for group F. The onset of sensory block and duration of motor and sensory block were recorded. Results: The mean onset time of sensory block in three groups were the same and about 8-9 minutes . The duration of complete motor block in group E (46.5 min) and F (45.3 min) were significantly higher than group N (22.5 min). The duration of sensory block in group E (117 min) was higher than group N and F (102 min). Hypotension happened in 40%, 50% and 60% of cases and bradycardia in 10%, 25% and 30% of cases of groups N, E and F respectively. Conclusion: The results of this study showed that there were no effects on onset time of epidural sensory block with epinephrine or fentanyl as an additive to lidocaine 2% but they have glittery direct effects on the duration of motor block. However, epinephrine can increase the duration of sensory block with lidocaine in epidural anesthesia. We suggest that in cases that relaxation and complete motor block is needed in epidural anesthesia epinephrine or fentanyl be added to lidocaine.