[Effects of lidocaine cervical epidural blockade on respiratory function].

ABSTRACT

Cervical epidural anesthesia with 2% lidocaine has been shown to reduce ventilatory capacity in patients with normal lungs by Dr. Bromage. It is important to evaluate the respiratory effect of this technique which may induce intercostal and phrenic nerve paralysis. After institutional approval and informed content had been obtained, 50 patients undergoing OR & IR of upper limbs, mean age 24 +/- 4 yrs mean weight 65 +/- 6 kg, ASA status I-II without preoperative pulmonary dysfunction were studied. C7-T1 intervertebral space was identified by the hanging-drop technique using a 16G Tuochy needle. A catheter was inserted cranially to a distance of 12 cm. Pulmonary function measurement and arterial blood gas data were obtained before and 20', 50', 105' min after injection of 12 ml 2% plain lidocaine. The anesthesia levels were between C3-T3 and obtained at 13 +/- 2 min. Mean arterial blood gas analysis showed mild respiratory acidosis at 20 min (PaCO2 46.0 +/- 3.5 mmHg). The measured values of IVC, VC, FVC, FEV1, PEF, when compared with control values were decreased over 15.60% of control values and 20% of predicted data at 20 min. The ratio of FEV1/VC, FEV1/FVC were still within normal limit (greater than 80%). The result was significantly compatible to the criteria of mild type of pulmonary function test. No respiratory distress was complained of and only cause little change of arterial blood gas.(ABSTRACT TRUNCATED AT 250 WORDS)