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Master Thesis

Lidocaïne 2% adrénalinée alcalinisée par bicarbonate de sodium 4.2% ou lidocaïne 2% adrénalinée pour extension d'une analgésie péridurale obstétricale pour césarienne non programmée : comparaison rétrospective du délai d’obtention d’une anesthésie chirurgicale

Abstract : Introduction: since the 1990s, the gold standard for anesthesia in case of a non elective cesarean section during labour is a top-up epidural injection of 15-20 mL of lidocaine 2% with epinephrine, allowing surgical incision to be made within a time frame that is sometimes incompatible with the urgency of the need for fetal extraction. The use of lidocaine 2% with epinephrine buffered with sodium bicarbonate, adopted by part of our team, shortens the time required to reach a surgical anaesthesia. The data in the current literature, although promising, are insufficient for it to be recommended for non elective cesarean section, including situations of fetal distress. Methods: we conducted a retrospective study in our Anesthesiology Department comparing the time to reach surgical anesthesia after an epidural top-up of lidocaine 2% with epinephrine 10 mL with sodium bicarbonate 4.2% 2 mL, or lidocaïne 2% with epinephrine 20 mL. Fifty-one files between 01/01/2019 and 31/07/2019 were included for statistical analysis. The principal outcome was the time from the end reinjection to reach cold anesthesia level T4. Different times, maternal complications and fetal parameters were observed as secondary outcomes. Results: time to reach surgical anesthesia with buffered lidocaine 2% with epinephrine was faster than with lidocaine 2% with epinephrine alone : 4.8 (+/-2.2) min Vs 10.4 (+/-3.5) min (p < 0.001). There are no differences in maternal or fetal side effects nor complications. Conclusion: the extension of an obstetrical epidural analgesia with buffered lidocaine allows the surgical incision to be performed twice as fast as with lidocaine alone, with a reassuring safety profile.
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https://dumas.ccsd.cnrs.fr/dumas-03034271
Contributor : Médecine Ub <>
Submitted on : Tuesday, December 1, 2020 - 4:39:33 PM
Last modification on : Thursday, January 21, 2021 - 3:10:31 AM

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  • HAL Id : dumas-03034271, version 1

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Jérémy Henriot. Lidocaïne 2% adrénalinée alcalinisée par bicarbonate de sodium 4.2% ou lidocaïne 2% adrénalinée pour extension d'une analgésie péridurale obstétricale pour césarienne non programmée : comparaison rétrospective du délai d’obtention d’une anesthésie chirurgicale. Sciences du Vivant [q-bio]. 2019. ⟨dumas-03034271⟩

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