BUPIVACAINE 0.125-PERCENT IMPROVES CONTINUOUS POSTOPERATIVE EPIDURAL FENTANYL ANALGESIA AFTER ABDOMINAL OR THORACIC-SURGERY

The addition of 0.125% and 0.25% bupivacaine to continuous postoperative epidural infusions of fentanyl, in a 10 mu g.mi(-1) concentration, were studied in 39 patients following abdominal or thoracic surgery in prospective, random, double-blind fashion. Patients received an initial bolus of 0.1 ml.kg(-1) of the the study solution and an infusion of 6 ml.hr(-1) which was titrated to maintain analgesia (VAS < 40). Assessments of pain (VAS), pulmonary function (pH, PaCO2), and bowel function (time to flatus or po fluids) were made until the second postoperative morning. There was a difference among the three groups in analgesia (means VAS scores) over time (P < 0.01), with the fentanyl-alone group producing less analgesia than the 0.125% bupivacaine group (P < 0.01). There was no difference in the average infusion rates, postoperative pulmonary function, or bowel function. The incidence of side effects including somnolence, nausea and vomiting, and pruritus was also similar.