The Evaluation of Perioperative Safety of Local Anesthesia with Lidocaine Containing Epinephrine in Patients with Ischemic Heart Disease

  • Mehdi Sanatkar Department of Anesthesiology, Razi Hospital, AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences,Tehran, Iran. AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Mostafa Sadeghi Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Nafiseh Esmaeili Autoimmune Bullous Disease Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Mohammad Hassan Naseri Department of Cardiac Surgery, Baqiyatallah University of Medical Sciences, Tehran, Iran.
  • Hossein Sadrossadat Mail Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Mehrdad Shoroughi Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Hamid Reza Fathi Department of Plastic Surgery, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Shahrokh Ghazizadeh Department of Plastic Surgery, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Anesthesia, Epinephrine, Ischemic heart disease, Lidocaine

Abstract

The use of local anesthesia with lidocaine containing epinephrine in patients with cardiac disease is controversial in the literature. The aim of our study was determining the safety of use the local anesthesia contain epinephrine in patients with ischemic heart disease that undergoing reconstructive surgery. Thirty two patients that had known ischemic heart disease and candidate to undergo reconstructive surgery for skin tumor enrolled in this study.  All patients continued their medication for cardiac disease till morning of the operation. 10 ml lidocaine 2% containing 1:100,000 epinephrine was injected in patients for local anesthesia. The hemodynamic changes and electrocardiographic variables before injection were compared with them after injection, during surgery and till 6 hours postoperation period. A 12 lead electrocardiogram was recorded in all our cases for detection of myocardial ischemic changes. The mean age, weight and height were 58.2±10.4, 74.8.±14.4 kg and 164.5± 8 cm respectively. Twelve patients (37.5%) were diagnosed with systemic hypertension and 10 patients with diabetes (31.2%). The comparison of change of systolic, diastolic and mean blood pressure between baseline, during procedure and after operation defined that our subjects did not have any significant disturbance in blood pressure in perioperative period. The comparison of baseline heart rate with heart rate after injection, during procedure and in postoperation period indicated a significant changes in this variable (P=0.044). The heart rhythm during the perioperative period also failed to exhibit alterations. The ischemic change was not recorded in our patients before injection compared to after injection. None of our patients have any early complications because of infiltration of local anesthetic containing epinephrine in our patients. The use of 10 ml 2% lidocaine with epinephrine 1:100,000 in patients with cardiac disease represent a safe anesthetic procedure. These patients experienced a more profound anesthesia with hemodynamic stability and without myocardial ischemic changes.

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How to Cite
1.
Sanatkar M, Sadeghi M, Esmaeili N, Naseri MH, Sadrossadat H, Shoroughi M, Fathi HR, Ghazizadeh S. The Evaluation of Perioperative Safety of Local Anesthesia with Lidocaine Containing Epinephrine in Patients with Ischemic Heart Disease. Acta Med Iran. 51(8):537-542.
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