• G Capogna, D Celleno, G Varrassi, M Emanuelli, M Sebastiani, F Muratori, G Cipriani, and M Tomassetti.
• Department of Anesthesiology, Fatebenefratelli Isola Tiberina General Hospital, Rome, Italy.
• J Clin Anesth. 1991 May 1; 3 (3): 211-4; discussion 214-5.

Study ObjectiveTo determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section.DesignRandomized, double-blind, placebo-controlled (standard commercial preparation of 2% mepivacaine with epinephrine) study.SettingInpatient obstetric department at a general hospital.PatientsSeventy patients scheduled for elective cesarean section under epidural anesthesia.InterventionsTwo groups of 35 patients each receiving either the standard commercial preparation of mepivacaine or the pH-adjusted solution (prepared with the addition of 0.1 meq/ml of sodium bicarbonate to the standard commercial solution).Measurements And Main ResultsMeasurements of sensory (pinprick) and motor (Bromage's criteria) block were taken at 1- to 2-minute intervals beginning after the completion of the epidural injection. Increasing the pH of the mepivacaine resulted in a significant shortening of the time of analgesia onset (9.3 minutes compared with 16.01 minutes, p less than 0.01) and of peak effect (11.1 minutes compared with 21.2 minutes, p less than 0.01). The alkalinization did not affect duration of the block, intensity of motor block, or mean dose of local anesthetic used.ConclusionThe alkalinization allowed the surgery to proceed more rapidly, significantly decreasing the time interval between epidural block and delivery of the infant.

28 keywords...

hide…