Changes of the T-wave on range of spinal blockade after low dose epinephrine administration

ABSTRACT

BACKGROUND: Epidural test solution is administered to confirm the correct positioning of an epidural catheter. Hemodynamic changes after administration of epidural test solution reportedly help confirm intravenous (IV) placement of epidural catheters. The change in T wave amplitude is important for checking intravascular placement of epidural catheters. We examined changes in T wave amplitude according to the level of spinal anesthesia after IV epinephrine administration. METHODS: Eighty-one healthy patients undergoing spinal anesthesia were randomized into three groups: group C (control), group L (low spinal block), and group H (high spinal block). All patients received an IV administration of test solution, 3 ml of 1% lidocaine and epinephrine 10 µg. Systolic blood pressure (SBP), heart rate (HR), and T wave amplitude were measured up to 5 min after test solution administration. Adverse reactions post administration of test solution were also recorded. RESULTS: In all groups, after administration of IV test solution, SBP and HR increased, and the T wave amplitude decreased. There were no significant differences in HR, SBP, and T wave amplitude changes between the groups after administrating test solution. Fifteen out of 25 patients (60.0%), 10 out of 24 (41.6%), and 11 out of 23 (47.8%) complained of adverse symptoms in groups C, L, and H, respectively. CONCLUSIONS: This study suggests that change in T wave amplitude after administration of a low dose of epinephrine is not affected by the spinal block range.