Cardiovascular effects of spinal and epidural anesthesia

The cardiovascular effects of epidural anesthesia are complex and are related to the level of anesthesia, the amount of anesthetic injected, the addition of epinephrine to the local anesthetic solution and the clinical of the patient. In general, these results indicate that spinal anesthesia tends to produce a greater degree of cardiovascular depression as demonstrated by the greater fall in mean arterial pressure, cardiac output and heart rate. Thus, at similar levels of anesthesia, spinal blockade produces a greater depression of the cardiovascular system than does epidural anesthesia, which probably reflects a higher level of sympathetic blockade following similar analgesic levels of spinal and epidural anesthesia.