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B81 Cardiovascular effects of adrenaline containing local anaesthetics in elective upper limb surgeries
  1. A Ali1,
  2. Z Sheikh2 and
  3. M Abusayed3
  1. 1Kings Mill Hospital, Sutton in Ashfield, UK
  2. 2University Hospital of Derby and Burton, Derby, UK
  3. 3Walsall Manor Hospital NHS Trust, Walsall, UK


Background and Aims Due to paucity of information and the fact that most of the work done was related to dental work(1). We investigated the haemodynamic changes associated with the use of adrenaline containing local anaesthetics and whether those changes are more prominent in hypertensive patients.

Methods We carried out a service evaluation project (July 2019- July 2020) we prospectively collected data of 46 patients who underwent elective upper limb surgeries under regional blocks. Interscalene, supraclavicular and axillary blocks were used with or without midazolam sedation (doses up to 3mgs).

Exclusion criteria were patients less than 16 years old, pain or discomfort during the procedure, general anaesthesia, propofol sedation or use of beta blockers or anticholinergics.

34 patients had adrenaline containing local anaesthetics in their blocks. Eleven patients of this group had a history of hypertension.

Twelve patients had their blocks with non-adrenaline containing local anaesthetics.

Results No significant changes in systolic blood pressurein both adrenaline and non-adrenaline groups (median 1% increase in adrenaline group and 0.5% fall in non-adrenaline group)

The adrenaline group showed higher increase in heart rate (median 11.5% increase) compared to non-adrenaline group (median 3.5% increase). This effect was slightly more evident in hypertensive patients receiving adrenaline containing local anaesthetics (median 18% rise).

Conclusions Use of adrenaline containing local anaesthetics was associated with slightly higher rise in heart rate compared to plain local anaesthetics. The rise in heart rate was more prominent in hypertensive patients. Larger studies and more work are required to establish the clinical significance of the results.

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