The components of an effective test dose prior to epidural block

Abstract

From a study in 215 patients and 10 volunteers, it is concluded that for a single test dose of a local anesthetic solution to be of value in signalling in all patients the possibility of an intravascular or subarachnoid injection while performing epidural block, it must contain 0.015 mg epinephrine and a milligram dose of the local anesthetic drug which rapidly results in evidence of spinal anesthesia. Furthermore, it must be monitored meticulously, preferably with an electrocardioscope. If the effects of a beta-blocker are present, then the blood pressure must also be monitored.