Subjective experiences of anesthesiologists undergoing epidural anesthesia.

Abstract

BACKGROUND AND OBJECTIVES:

This study reports subjective experiences of nine anesthesiologists undergoing three consecutive epidural anesthetics.

METHODS:

Eight anesthesiologists and one nurse anesthetist, all ASA physical status 1, underwent three lumbar epidural anesthetics as part of another study. Epidural catheters were inserted via a 17-gauge Tuohy needle without sedation after local anesthesia with pH adjusted lidocaine at the second, third, or fourth lumbar interspace. Three local anesthetics (2% lidocaine HCl, 3% chloroprocaine HCl, and 0.75% bupivacaine HCl) were administered each separated by at least 48 hours. The local anesthetic was incrementally injected via the epidural catheter to achieve at least a T-1 dermatome level of analgesia. Each subject completed a written questionnaire at the end of the study regarding their experience.

RESULTS:

Most of the subjects (7 of 9) had no prior epidural anesthesia. Eight of nine subjects experienced at least one paresthesia during catheter insertion; this was uniformly described as a "poorly localized burning sensation," radiating to the hip or leg. All subjects reported difficulty taking a deep breath and coughing with a T-1 level of analgesia. Eight of nine subjects reported dysphoria during lidocaine epidural anesthesia. Eight of nine subjects reported moderate back pain after dissipation of chloroprocaine epidural anesthesia.

CONCLUSIONS:

All volunteers stated that they would change their anesthetic practice as a result of participation in this study. They believed that having experienced an epidural anesthetic made them better qualified to prepare patients for this anesthetic technique.

• Authors: R Hetherington, R A Stevens, J L White, L Spitzer, S Koppel
• Journal: Regional anesthesia (Reg Anesth) 1994 Jul-Aug Vol. 19 Issue 4 Pg. 284-8 ISSN: 0146-521X [Print] United States
• PMID: 7947430 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anesthetics, Local
• Procaine
• chloroprocaine
• Lidocaine
• Bupivacaine

Topics

• Adult
• Anesthesia, Epidural (adverse effects)
• Anesthesiology
• Anesthetics, Local
• Bupivacaine
• Humans
• Lidocaine
• Nurse Anesthetists
• Pain (chemically induced)
• Pain Measurement
• Physicians
• Procaine (analogs & derivatives)