Postoperative extradural analgesia following thoracic surgery: a feasibility study.
The feasibility of providing postoperative analgesia using thoracic extradural blockade following thoracotomy has been assessed. Extradural block was produced by intermittent injections of 0.5% bupivacaine with adrenaline 1:200,000 or a continuous infusion of 0.25% or 0.125% bupivacaine. The only toxic symptom was drowsiness which was most frequent after a continuous infusion of 0.25% bupivacaine and with arterial plasma bupivacaine concentrations above 1.5 mug/ml. Arterial hypotension was a troublesome complication with all techniques although stability of arterial pressure was more easily achieved with a continuous infusion technique. However, this produced a high incidence of urinary retention. Practical aspects and effectiveness of providing extradural analgesia in patients following thoracotomy are discussed.
D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood; D004837:Epinephrine; D005260:Female; D005283:Fentanyl; D006221:Halothane; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D013874:Thiopental; D014555:Urination Disorders / Q000139:chemically induced
D013874:Thiopental; D005283:Fentanyl; D006221:Halothane; D002045:Bupivacaine; D004837:Epinephrine