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KMID : 0356920170700020171
Korean Journal of Anesthesiology
2017 Volume.70 No. 2 p.171 ~ p.176
Effect of an epinephrine mixture for interscalene block on hemodynamic changes after the beach chair position under general anesthesia: a retrospective study
Kim Bum-June

Lim Chae-Seong
Hong Boo-Hwi
Lee Ji-Yong
Lee Sun-Yeul
Lee Jung-Un
Kim Yoon-Hee
Lee Won-Hyung
Yoon Seok-Hwa
Abstract
Background: The beach chair position (BCP) can cause significant hypotension. Epinephrine is used to prolong the duration of local anesthetics; it is also absorbed into blood and can exert systemic effects. This study determined the effects of epinephrine mixed with ropivacaine for an interscalene block (ISB) on hemodynamic changes related to BCP.

Methods: Patient data collected from March 2013 to August 2014 were used retrospectively. We divided the patients into three groups: 1) ISB only, 2) I+G (general anesthesia after ISB without epinephrine), and 3) I+E+G (general anesthesia after ISB with epinephrine). Mean blood pressure (MBP) and heart rate (HR) were measured for 30 minutes at 5-minute intervals.

Results: The study analyzed data from 431 patients. MBP tended to decrease gradually in the groups I+G and I+E+G. There were significant differences in MBP between the groups I+G and I, and between the groups I+G and I+E+G. Group I+E+G showed a significant increase in HR compared with the other two groups.

Conclusions: ISB with an epinephrine mixture did not prevent hypotension caused by the BCP after general anesthesia. HR increased only in response to the epinephrine mixture. A well-planned prospective study is required to compare hemodynamic changes in that context.
KEYWORD
Blood pressure, Epinephrine, Heart rate, Hemodynamics, Postural balance, Shoulder arthroscopic surgery
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