title: Epidural infusion of bupivacaine and diamorphine for postoperative analgesia. Use on general surgical wards.
abstract: An audit of postoperative epidural analgesia in a District General Hospital is presented. Three hundred and forty-eight patients received epidural infusions of a bupivacaine and diamorphine mixture, and were managed on general surgical wards using a standard protocol of observations and instructions. Good analgesia was achieved in 339 (97%) patients. Respiratory depression, defined as a respiratory rate of eight breaths.min-1 or less, occurred in 22 (6%) patients, was of gradual onset, and was simply and successfully managed without morbidity. There were no respiratory arrests. Other complications, and the significance of catheter insertion level are discussed.
authors.affiliation: Department of Anaesthesia, Royal Devon and Exeter Hospital Wonford.
authors.forename: G J
authors.initials: GJ
authors.lastname: Hobbs
authors.forename: F L
authors.initials: FL
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D003932:Heroin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D012131:Respiratory Insufficiency / Q000139:chemically induced; D013514:Surgical Procedures, Operative
chemical_list: D003932:Heroin; D002045:Bupivacaine