Epinephrine test dose in children: is it interpretable on ECG monitor?
Varghese, E; Deepak, KM; Chowdary, KVR
| HERO ID | 531240 |
|---|---|
| In Press | No |
| Year | 2009 |
| Title | Epinephrine test dose in children: is it interpretable on ECG monitor? |
| Authors | Varghese, E; Deepak, KM; Chowdary, KVR |
| Journal | Paediatric Anaesthesia |
| Volume | 19 |
| Issue | 11 |
| Page Numbers | 1090-1095 |
| Abstract | P>Background: Epidural and other regional blocks are performed in children under general anesthesia; the response to a 'test dose' may be altered during administration of general anesthetics. Limited data is available describing changes in electrocardiogram, blood pressure and heart rate (HR) following unintentional intravascular injection of a lidocaine-epinephrine-containing test dose, under sevoflurane anesthesia in children. Methods: Sixty-eight children undergoing elective surgeries under sevoflurane anesthesia were administered 0.1 ml center dot kg-1 of 1% lidocaine with epinephrine 0.5 mu g center dot kg-1 or normal saline intravenously, to simulate an accidental intravascular test dose. T-wave changes in lead II on the anesthesia monitor and on a printed ECG were noted over the initial 1 min as well as changes in HR and systolic blood pressure (SBP) over an initial 3 min period. Results: Following injection of lidocaine-epinephrine, a significant increase in T-wave amplitude in lead II was noted in 91% of children on the ECG monitor and in 94% of children on the ECG printout of the same lead. In 64% of children, an increase in HR of >= 10 b center dot min-1 and in 76% of children an increase in SBP of >= 15 mmHg was noted. Conclusion: An increase in T-wave amplitude can easily be detected by carefully observing the ECG monitor or an ECG printout within a minute following the accidental i.v. administration of 0.1 ml center dot kg-1 of 1% lidocaine-epinephrine (0.5 mu g center dot kg-1) regional anesthetic test dose in children under sevoflurane anesthesia. |
| Doi | 10.1111/j.1460-9592.2009.03154.x |
| Pmid | 19807887 |
| Wosid | WOS:000270551800009 |
| Is Certified Translation | No |
| Dupe Override | No |
| Is Public | Yes |
| Language Text | English |
| Keyword | children; epidural test dose; lidocaine epinephrine test dose; T-wave; amplitude; intravascular injection; anesthetized children; regional anesthesia; sevoflurane |
| Is Qa | No |