Efficacy of adrenaline, lignocaine-adrenaline and isoprenaline as a test dose in halothane-anaesthetized lambs

Abstract

It has been shown that an epidural test dose with adrenaline does not always detect an intravascular injection in halothane-anaesthetized children. To ascertain whether test dosing with other agents might be more useful, we sought to determine if and at what dose levels three different intravenous drugs (adrenaline, isoprenaline and 1% lignocaine with 1/200,000 adrenaline) produced an increase in heart rate (HR) in halothane-anaesthetized lambs. Eight 2-week-old lambs were anaesthetized with 1% halothane in oxygen. The lambs were intubated and ventilated in order to maintain end-tidal and arterial CO2 within normal limits; HR and blood pressure before and 15-180 s after the injection of four increasing doses of each drug were recorded. The same set of measurements was repeated after the intravenous injection of atropine 10 micrograms kg-1. Adrenaline-containing doses produced a more sustained increase in HR (P less than 0.05, ANOVA) at lower doses of adrenaline when atropine was injected first. This increase did not occur in all lambs, and dysrhythmias were manifest in some. Isoprenaline always produced a significant increase in HR without dysrhythmias whether atropine was given or not. We conclude that in halothane-anaesthetized lambs, isoprenaline is a more reliable indicator of intravascular injection than adrenaline.