할로탄 마취하에서 국소 투여된 에피네프린이 심맥관계에 끼치는 영향에 관한 임상적 연구

A clinical study on the cardiovascular effects of locally administrated epinephrine during halothane anesthesia

The 2% lidocaine HCl with epinephrine is commonly injected locally for local hemostasis during oral and maxillofacial surgery. The epinephrine is also injected intravenously or local infiltration to increase arterial blood pressure and pulse rate. The author performed a clinical study on the cardiovascular effects; E.K.G. change, artierial blood pressure and pulse rate after infiltration of 2% lidocaine HCl containing 1: 50,000 epinephrine during halothane general anesthesia in 48 patients who were physical status I of the American Society of Anesthesiologists nomenclatures and operated the elective surgery in department of oral and maxillofacial surgery in Won Kwang University Dental Hospital from August 1986 to Jyly 1987. And, they were classified 4 groups by dosage of epinephrine; Group Ⅰ: the dosage of epinephrine was ranged from 0 to 0.036㎎, Group Ⅱ: range from 0.036㎎ to 0.072㎎, Group Ⅲ: ranged from 0.072㎎ to 0.108㎎. Group Ⅳ: ranged from 0.108㎎ to 0.144㎎. The obtained results were as follows; 1. Cardiac arrhythmias were observed 14 patients (29.2%) of 48 patients after infiltration of 2% lidocaine HCl with 1: 50,000 epinephrine. 2. The arterial blood pressure were increased at 5 minutes remarkablely after infiltration of 2% lidocaine HCl with 1: 50,000 epinephrine, but there was no statistical significance. 3. It is better starting operation after 5 minutes after infiltration of 2% lidocaine HCl with 1: 50,000 epinephrine. 4. When we compared the preoperative abnormal electrocardiogram group with the normal group, occurance rate of cardiac arrhythmia of both group were similar. 5. Cardiac arrhythmias were disappeared without specific treatment except one case and severe and fetal cardiac arrhythmias were not observed. Therefore, it is concluded that we can use epinephrine as much as 0.144㎎ (4 cartridges of lidocaine HCl with epinephrine 1: 50,000) for local hemostasis during halothane general anesthesia.