The Prevention of Hypotension After Epidural Analgesia After Major Surgery

Summary

Epidural analgesia via continuous epidurally infused local anesthetic agent (LA) is widely and very successfully used routinely for perioperative pain control in patients undergoing major orthopedic and abdominal surgery since 1928. The choice currently depends on the preference of the APS physician in charge of the case. A frequent unwanted side effect of epidural block is hypotension due to the epidurally injected LA blocking the sympathetic nerves and thus the patient's response to hypotension, which is usually due to hypovolemia and/or an unopposed parasympathetic (via the vagus nerve) nervous system. The purpose of this research study is to see if adding epinephrine, to the epidural anesthetic will decrease possible side effects, such as low blood pressure, and lead to a better effect of the epidural anesthetic.

Timeline

Start

2016-11-15

Primary completion

2017-10-04

Completion

2018-09-14

Publications

• Nin OC, Boezaart A, Giordano C, Hughes SJ, Parvataneni HK, Reina MA, Schirmer A, Vasilopoulos T. Pilot epinephrine dose-finding study to counter epidural-related blood pressure reduction. Reg Anesth Pain Med. 2025 Nov 5;50(11):901-906. doi: 10.1136/rapm-2024-105406.

Drugs

Indications