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Anesth Analg 1988; 67:356-359
© 1988 International Anesthesia Research Society
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Skin Pulse Wave Monitoring during Lumbar Epidural and Spinal Anesthesia

Joop Meijer, MD, Jaap J. de Lange, MD, PhD, and Henk H. Ros, PhD

Received from the Department of Anesthesiology, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, The Netherlands.

Abstract

The effectiveness of pulse wave monitoring of the big toes was compared with loss of cold discrimination to determine the onset of nerve blockade during lumbar epidural and spinal anesthesia. Forty-seven patients scheduled for elective urologic or lower extremity operations were assigned to one of three groups. Group 1 (15 patients) received epidural mepivacaine 1.5% with epinephrine; group 2 (12 patients), epidural bupivacaine 0.5%, and group 3 (20 patients), spinal bupivacaine 0.5%. In the epidural groups, the mean time to onset of increases in pulse wave amplitude was less than half the mean time to onset of decrease in cold discrimination (P < 0.05). In patients given spinal anesthesia, there was no significant difference. The pulse wave monitor seems to be a sensitive and objective detector of early anesthetic effect during spinal and epidural anesthesia.

Key Words: ANESTHETIC TECHNIQUES—epidural, spinal






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.