Bupivacaine lidocaine epinephrine infiltration as local anaesthetic in middle ear surgery. arrhythmogenic and analgesic potential

ABSTRACT

Cooperation of patients undergoing middle ear surgery under local anaesthesia provides feed back stat guide, whereas integrity of facial nerve as well as hearing can be tested. Yet, infiltration of epinephrine to produce haemostasis, carries the danger to produce cardiac arrhythmia. This study was conducted to evaluate the arrhythmogenic and analgesic potential of bupivacaine - lidocaine - epinephrine infiltration as local anaesthetic in middle ear surgery. One hundred adult patients of either sex scheduled for middle ear surgery were included in this study. Local anaesthesia was achieved by injection of 5-10 ml of a mixture of bupivacaine, lidocaine epinephrine [150.000]. Patients were monitored as regard heart rate, systolic and diastolic blood pressures. Post operative analgesia was, also assessed. There were insignificant increase in heart rate and systolic blood pressure 5 minutes after infiltration which declined gradually near basal value. No arrhythmia was detected. Postoperative analgesia was excellent. In conclusion, bupivacaine - lidocaine epinephrine local infiltration provides excellent surgical anaesthesia, stable haemodynamics and eventual post operative course with high degree of analgesia