Epidural anaesthesia with mixtures of bupivicaine and lidocaine

Abstract

In arandomized double-blind trial in 30 patients receiving lumbar epidural anaesthesia, the onset and duration of sensory blockade with 0.375 per cent bupivicaine was compared with amixture of 0.375 per cent bupivicaine and one per cent lidocaine hydrochloride and amixture of 0.375 per cent bupivicaine and one per cent carbonated lidocaine. Onset (9.3 ± 7.76 minutes) and complete spread (23.3 ±4.8 minutes) for bupivicaine was significantly slower than in the mixtures containing carbonated lidocaine (onset 4.7 ± 0.48 minutes, complete spread 14.8 ± 2.49 minutes) and lidocaine hydrochloride (onset 5.0 ± 0.67 minutes, complete spread 16.3 ± 3.2 minutes). There was no significant difference in times of onset and complete spread between the two mixtures. The duration of sensory blockade for bupivicaine alone (165 ± 20 minutes) was not significantly different from the duration in either the mixture containing carbonated lidocaine (161 ± 51.24 minutes) or lidocaine hydrochloride (143 ± 33.7 minutes). The results indicate aclinical advantage in speed of onset without significant shortening of duration of action for mixtures of carbonated lidocaine or lidocaine hydrochloride with bupivicaine as compared to bupivicaine alone. © 1983 Canadian Anesthesiologists.