Regional-Anaesthesie
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Regional-Anaesthesie · Oct 1985
Comparative Study Clinical Trial Controlled Clinical Trial[Comparison of prilocaine 2% versus lidocaine 2% with adrenaline in peridural anesthesia. A clinical double-blind study].
Sensory and motor blockade as well as formation of methaemoglobin were investigated under controlled double-blind conditions following epidural anaesthesia with prilocaine 2% or lignocaine 2%, each with adrenaline 1:200,000. 20 ml (= 400 mg) of these two solutions were administered to two groups, each consisting of 10 patients. Sensory blockade was tested with the pin prick method, motor blockade with the Bromage score and the rectus abdominis-muscle (RAM)-test. Venous methaemoglobin was determined before and 2,5 h after administration of the local anaesthetic. ⋯ Methaemoglobin always increased following prilocaine, but not following lignocaine. One patient had an increase of methaemoglobin from 0.8 rel% before to 13.8 rel% after administration of prilocaine. The differences of sensory and motor blockade are of secondary importance for clinical practice; while lignocaine shows higher toxicity to the central nervous and cardiovascular system, prilocaine forms methaemoglobin.