A comparison of five solutions of local anaesthetics and/or sufentanil for continuous, postoperative epidural analgesia after major urological surgery.
OBJECTIVE
The aim of the present study was to compare and assess the quality of analgesia, the safety and the side-effects after the use of a continuous, thoracic epidural infusion of sufentanil (5 microg h(-1)), 0.25% bupivacaine (10 mL h(-1)), 0.2% ropivacaine (10 mL h(-1)) alone or in combination in patients who had undergone major urological surgery. This prospective, randomized, double-blinded study investigated the efficacy of thoracic epidural infusions after major urological surgery.


METHODS
Patients received a 72-h continuous infusion (10 mL h(-1)) of 0.25% bupivacaine (B), 0.2% ropivacaine (R), 0.25% bupivacaine with 0.5 microg mL(-1) sufentanil (BS), 0.2% ropivacaine with 0.5 microg mL(-1) sufentanil (RS) or 0.5 microg mL(-1) sufentanil only (S). The analysis included 109 patients.


RESULTS
The mean visual analogue scale (VAS) scores for pain were highest in the groups R and S (P < 0.001). The PaCO2 values were significantly higher in the groups RS and S (P = 0.003). Motor block occurred more frequently in the groups B and BS than in the other groups (P < 0.001). Sedation, nausea and pruritus were more common in the groups that received sufentanil.


CONCLUSIONS
A continuous, epidural infusion with these drugs was safe and effective in our patients. The combination of 0.2% ropivacaine plus sufentanil appeared preferable because of the low incidence of motor block.
Hübler
M
M
Department of Anaesthesiology, University Hospital Carl-Gustav-Carus, Dresden, Germany.
Litz
R J
RJ
Sengebusch
K H
KH
Kreinecker
I
I
Frank
M D
MD
Hakenberg
O W
OW
Albrecht
D M
DM
D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002245:Carbon Dioxide / Q000097:blood; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D019999:Pharmaceutical Solutions; D015656:Respiratory Mechanics / Q000187:drug effects; D000077212:Ropivacaine; D017409:Sufentanil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013520:Urologic Surgical Procedures
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004338:Drug Combinations; D019999:Pharmaceutical Solutions; D002245:Carbon Dioxide; D000077212:Ropivacaine; D017409:Sufentanil; D002045:Bupivacaine