Regional anesthesia
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Regional anesthesia · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialAging reduces the reliability of epidural epinephrine test doses.
The authors recently determined that intravascular injection of an epinephrine test dose reliably produced an increase in heart rate > or = 20 beats/min in young individuals. However, aging is associated with a significant reduction in beta-adrenergic responsiveness. This study was designed to determine whether aging decreases the magnitude of heart rate (HR) increase after intravascular injection of epinephrine. ⋯ Aging is associated with a reduction in the magnitude of HR increase after intravenous injection of epinephrine. The results suggest that to detect an intravascular injection in healthy people, a test dose containing 10 micrograms epinephrine will suffice before the age of 40. However, even 15 micrograms epinephrine will not be totally reliable in older patients, owing to decreased beta-adrenergic responsiveness.