Reversal of Bupivacaine 0.5% Epidural Anesthesia Using Epidural Saline Washout

Abstract

Background: Prolonged motor and sensory block following epidural anesthesia has been associated with patient dissatisfaction. Administration of epidural crystalloids in patient who had received bupivacaine 0.75% and lidocaine 2% epidural anesthesia. However, bupivacaine 0.5% is commonly used in our institutional and the effectiveness of bolus of NS in non-obstetrical patients undergoing 0.5% bupivacaine epidural anesthesia has not been investigated. The objective of this study was to determine the relationship of normal saline (NS) epidural flush volume to the recovery of motor and sensory block and its hemodynamic stability (blood pressure and heart rate) in non-obstetrical patients undergoing epidural anesthesia using 0.5%  bupivacaine. Methods: Following surgery, subjects with T6 dermatome level of sensory, were randomized to 2 treatment groups. Group 1 (control, n = 11) received 1-mL epidural normal saline (NS). Group 2 (experimental, n = 11) received an epidural bolus of 30-mL NS. Assesment of motor and sensory block was performed at 15-minute intervals until complete motor and sensory recovery. Hemodynamic stability (blood pressure and heart rate) between two groups were also monitor every 15-minutes and determined. Results: Times to full motor recovery were significantly faster in the epidural bolus of 30-mL groups than in the control group (69 ± 19.66 vs 95 ± 11.83; p = 0.0017).). Conclusions: A more rapid recovery of motor block in patients undergoing 0.5% bupivacaine epidural anesthesia can be achieved with the use of  30-mL NS epidural washout, with hemodynamic stability.