할로탄 전신 흡입마취중 국소 투여된 에피네프린이 심맥관계에 미치는 영향에 관한 임상적 고찰

CARDIOVASCULAR EFFECTS OF LOCAL INFILTRATION OF EPINEPHRINE DURING HALOTHANE ANESTHESIA IN MAN

During general anesthesia, 2% Lidocaine HCl containing 1:50,000 or 1:100,000 epinephrine is widely used for controlling hemorrhage in dental practice. But, a wide spread belief is that the use of epinephrine during general anesthesia in man with halogenated hydrocarbon may precipitate severe ventricular arrhythmias. The authors made a clinical study on the changes of arterial pulse rate, systolic blood pressure and EKG after injection of 0 to 10 ㎖ of 1 : 100,000 epinephrine (contained in 2% lidocaine. HCl:1.8 ㎖/cartridge) in 114 patients aged from 15 to 70 years who were considered physical status 1 (American Society of Anesthesiologists nomenclature), and performed elective surgery under halothane general anesthesia, in the department of oral & maxillofacial surgery, Seoul National University Hospital from January to October 1984. The results obtained were summarized as follows: 1) Cardiac arrhythmias were not observed after injection of epinephrine (less than 10㎖: 1:100,000) 2) There was considerable increase in arterial pulse rate with in 5 minutes after epinephrine injection, especially in Group Ⅱ, Ⅲ and Group A. 3) There was a little increase in systolic blood pressure after epinephrine injection in group Ⅰ, Ⅱ, Ⅲ, but there was no remarkable differences between the groups and no statistical significance. 4) In oral and maxillofacial surgery during halothane anesthesia, we believe that the use of locally injected 1:100,000 epinephrine within 10㎖ (2% lidocaine. HCl 5.6 cartridges with 1: 100,000 epi) is safe, provided that adequate ventilation is assured and routine precautions for the use of local infiltration are observed.