Effect of high thoracic or cervical epidural analgesia with lidocaine on pulmonary function

Abstract Introduction: High thoracic or cervical epidural analgesia (HTCEA) causes motor paralysis of the diaphragm and intercostal muscles, and impairs ventilatory parameters. Despite many reports about pulmonary dysfunction under HTCEA, little information is available on estimating the time course and degree of ventilatory impairment when different concentrations of lidocaine are administered. We performed this study to clarify how different concentrations of lidocaine used in upper-thoracic epidural anesthesia affect patients' ventilatory impairment. Patients and methods: Ten patients scheduled for epidural catheterization to treat their pain were enrolled. Epidural catheterization was established between the C7 and T3 intervertebral spaces. Using a cross-over design, each subject was randomly assigned to one of two groups. A single shot of 10 ml of lidocaine was injected through each patient's catheter on three consecutive days: day 1, the day after the catheter had been inserted; day 2, the day follo...