The effect of epinephrine added to the solution of lidocaine and tetracaine for spinal anesthesia was investigated in patients undergoing elective surgery of lower extremities. Thirty patients received 3ml of 2% lidocaine and 0.4% tetracaine and 30 patients received the solution with 0.1 mg of epinephrine added. A lumbar puncture was performed at the L2-3 interspace, using a midline approach with a 25-gauge spinal needle. Mean highest level of pinprick analgesia was Th6.1 without epinephrine and Th4.4 with epinephrine, and mean time for regression to Th10 was 2.3 hours without epinephrine and 3.6 hours with epinephrine. Progression of analgesia level was significantly faster and prolongation of duration was significant greater after adding epinephrine. No severe complications were found in any patients. We concluded that adding 0.1 mg of epinephrine to 3 ml of 2% lidocaine and 0.4% tetracaine could produce clinically useful prolongation of spinal analgesia.
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