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Maternal Hemodynamic Responses to Epinephrine-Containing Local Anesthetics in Mild Pre-Eclampsia
  1. A. Dror, MD,
  2. T. K. Abboud, MD,
  3. J. Moore, MD,
  4. F. Swart, MD,
  5. P. Mosaad, MD,
  6. H. Davis, MD,
  7. J. Gangolly, MD,
  8. M. Mantilla, MD,
  9. A. Makar, MD and
  10. N. Zaki, MD
  1. From the Department of Anesthesiology, Los Angeles County-University of Southern California Medical Center, Los Angeles, California


This study was undertaken to determine the maternal hemodynamic responses to epinephrine added to local anesthetics during lumbar epidural anesthesia for labor in 30 mildly preeclamptic patients. Group I (n=16) received 1.5% lidocaine with 1:200,000 epinephrine and group II (n=14) received plain 1.5% lidocaine in a double-blind randomized fashion. Parameters recorded included maternal blood pressures and heart rates, fetal heart rates, duration of analgesia, and neonatal outcome. None of the patients in group I developed hypertension after administration of lidocaine with epinephrine, and they had significant decreases in their mean systolic and diastolic blood pressures compared with baseline values ( P <0.05). No significant changes were observed in group II patients. Duration of anesthesia was significantly ( P <0.01) longer in group I (102.5 ± 6.5 minutes) compared with group II patients (55.7 ± 5.4 minutes) (mean ± SEM). All neonates had normal fetal heart rate patterns and had Apgar scores of 9 or more at 5 minutes. Results from this study suggest that mildly pre-eclamptic patients are not likely to experience hypertension when small amounts of epinephrine are injected epidurally.

  • Anesthesia
  • obstetrics
  • Obstetrics
  • pre-eclampsia
  • Anesthetic technique
  • epidural
  • Cardiovascular
  • epinephrine

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