Summary
In order to study the effect of epinephrine on the pharmacokinetics of lidocaine injected for stellate ganglion blockade, 6 patients free of hepatic or renal disease received 1.5 mg/kg of 1% lidocaine, with or without 1/200,000 epinephrine, injected via the anterior paratracheal approach. Using a crossover study design, each patient was investigated twice at least 4 days apart in a double-blind randomised manner. Venous blood samples were collected over 8 hours and plasma lidocaine concentrations were measured using gas liquid chromatography. There was no difference in time to block onset nor in quality of pain relief between the two solutions. No adverse events were observed in either group. The maximum concentration was significantly lower and the time to maximum concentration significantly delayed when epinephrine-containing solutions were used. In addition, the mean residence time was significantly longer when epinephrine was used. However, the difference in the elimination half-life was not statistically significant between the two treatment groups. It is concluded that epinephrine decreases the rate of absorption of lidocaine when injected for stellate ganglion blockade.
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Benhamou, D., Bourget, P., Marx, M. et al. Stellate Ganglion Blockade. Drug Invest 5, 309–312 (1993). https://doi.org/10.1007/BF03259236
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DOI: https://doi.org/10.1007/BF03259236