• Fu-Chao Liu, Jiin-Tarng Liou, Yuan-Ji Day, Allen H Li, and Huang-Ping Yu.
• Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.).
• Chang Gung Med J. 2009 Nov 1;32(6):643-9.

BackgroundAdministration of local anesthetics at body temperature has been reported to shorten the onset time of regional block; however, studies examining the effects of warmed lidocaine on the onset of epidural anesthesia are limited. Here, we ascertain whether warming lidocaine solution to body temperature shortens the time to onset of epidural anesthesia.MethodsEighty patients were randomly allocated into two groups of equal size. Both received 16 ml of lidocaine solution injected via the epidural route at the L4- 5 interspace, with one group receiving the solution at room temperature (RT, 18 degrees Celsius) and the other receiving the solution warmed to body temperature (BT, 36 degrees Celsius). Sensory blocks at the T10, T12, and L3 dermatomes, perianal region, and upper level dermatomes were assessed by pinprick and their onset times recorded. Patients with incomplete anal sensory block were excluded.ResultsSeventy-seven patients were included for analysis. The pH value of the local anesthetic solution was significantly increased at BT compared to RT (6.57 +/- 0.11 vs. 6.47 +/- 0.11, p < 0.05). Significantly shorter onset times of sensory block were observed at the T12 (10.03 +/- 3.55 vs. 11.71 +/- 3.76 min) and L3 (7.49 +/- 3.19 vs. 9.92 +/- 3.46 min) dermatomes for the BT compared to the RT group (p < 0.005). The onset time of sensory block at the anal region was also shorter in the BT than the RT group (11.54 +/- 4.35 vs. 12.50 +/- 4.06 min, p < 0.05). No differences between groups with respect to gender, age, height, weight, visual analogue pain score, upper sensory level, or adverse events were observed.ConclusionsAdministration of lidocaine at BT compared to RT shortens the onset time of sensory block in epidural anesthesia with no associated adverse effects.

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