Background and Aims Haemodynamic changes and cardiac arrhythmias are not uncommon in clinical practice, depending on patient features, surgical treatment and drugs administered.
Here we describe haemodynamic changes developed in young patients, soon after a local infiltration anaesthesia in day surgery.
Methods We retrospectively assessed the haemodynamic effect of 2% lidocaine with 0,0125mg/ml adrenaline (Li&AD group) administered for septorhinoplasty in 50 participants and a combination of 0,5% bupivacaine and 2% lidocaine with 0,0125mg/ml adrenaline (BLi&AD group) for breast augmentation in 50 participants. Blood pressure and heart rate were recorded before the induction of general anaesthesia, immediately, 5, 10 and 20 minutes after local infiltration anaesthesia (LIA) and the data were analyzed.
Results The systolic and diastolic blood pressures in the Li&AD group transitory increased at all measuring points (p<05). In the BLi&AD group, the blood pressure decreased at 5 and 10 minutes. There were significant differences in systolic blood pressure at 5 and 10 minutes after local anaesthetic administration and heart rate at all time points between the 2 groups in different regions. Li&AD administration increased the heart rate and decreased the diastolic blood pressure.
Conclusions Transitory changes of the heart rate and blood pressure may have been triggered by endogenous and/or exogenous epinephrine. Bupivacaine with 2% lidocaine solution for LIA reduces haemodynamic disturbances and prolongs analgesic effect. We highlight the need for careful preoperative evaluation, including anxiety assessment and treatment in all patients in day surgery.