engleski

The effect of injection speed on haemodynamic changes immediate after lidocaine/adrenaline infiltration of nasal submucosa under general anaesthesia

Background and Purpose: Substantial systemic absorption after adrenaline-containing local anaesthetic infiltration can cause transitional changes in heart rate and arterial blood pressure in humans even during general anaesthesia. The aim of this study was to determine the effect of injection speed of local infiltration of adrenaline- containing lidocaine solution on transitional haemodynamic changes during local infiltration of nasal submucosa under general anaesthesia. Patients and Methods: A retrospective, comparative, non-randomised, open study on 1–2 ASA physical status 83 patients, aged 18 to 81 years, scheduled for septoplasty, septorhinoplasty, classical or functional endoscopic sinus surgery was performed. All patients received the submucosal infiltration of 2%lidocaine containing adrenaline solution (2ml) plus adrenaline (0.025 mg) plus plain 2% lidocaine solution (5ml) before surgical incision. Two different infiltration techniques were identified: fast infiltration (Group F, n=40) and slower, incremental infiltation (Group S, n=43). Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) were recorded before, five minutes after and ten minutes after infiltration. Results: There was no significant difference in HR, SAP, DAP nor MAP between the F group and the S group. There was significant decrease of HR (p=0.006), SAP (p=0.018), DAP (p=0.029), and MAP (p=0.010) at 10 minutes point within the S group compared to baseline. There was significant decrease of HR (p=0.04) at the 10 minutes point within the F group compared to baseline. Conclusions: This study did not confimed that the speed of injection of lidocaine with adrenaline made any effect on haemodynamic changes during local infiltration of nasal submucosa.However it confirmed that lidocaine with adrenaline induced a decrease of blood pressure.

infiltration anesthesia; general anesthesia; local anesthetic; epinephrine; blood pressure; heart rate

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