Korean J Anesthesiol.  2017 Apr;70(2):171-176. 10.4097/kjae.2017.70.2.171.

Effect of an epinephrine mixture for interscalene block on hemodynamic changes after the beach chair position under general anesthesia: a retrospective study

• Kim BJ
• Lim CS
• Hong BH
• Lee JY
• Lee SY
• Lee JU
• Kim YH
• Lee WH
• Yoon SH

• KMID: 2377417
• DOI: http://doi.org/10.4097/kjae.2017.70.2.171

Abstract

BACKGROUND
The beach chair position (BCP) can cause significant hypotension. Epinephrine is used to prolong the duration of local anesthetics; it is also absorbed into blood and can exert systemic effects. This study determined the effects of epinephrine mixed with ropivacaine for an interscalene block (ISB) on hemodynamic changes related to BCP.
METHODS
Patient data collected from March 2013 to August 2014 were used retrospectively. We divided the patients into three groups: 1) ISB only, 2) I+G (general anesthesia after ISB without epinephrine), and 3) I+E+G (general anesthesia after ISB with epinephrine). Mean blood pressure (MBP) and heart rate (HR) were measured for 30 minutes at 5-minute intervals.
RESULTS
The study analyzed data from 431 patients. MBP tended to decrease gradually in the groups I+G and I+E+G. There were significant differences in MBP between the groups I+G and I, and between the groups I+G and I+E+G. Group I+E+G showed a significant increase in HR compared with the other two groups.
CONCLUSIONS
ISB with an epinephrine mixture did not prevent hypotension caused by the BCP after general anesthesia. HR increased only in response to the epinephrine mixture. A well-planned prospective study is required to compare hemodynamic changes in that context.

Keyword

Blood pressure; Epinephrine; Heart rate; Hemodynamics; Postural balance; Shoulder arthroscopic surgery

MeSH Terms

Anesthesia
Anesthesia, General*
Anesthetics, Local
Blood Pressure
Epinephrine*
Heart Rate
Hemodynamics*
Humans
Hypotension
Postural Balance
Prospective Studies
Retrospective Studies*
Anesthetics, Local
Epinephrine