title: A comparison of five solutions of local anaesthetics and/or sufentanil for continuous, postoperative epidural analgesia after major urological surgery.
abstract: 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.
authors: Department of Anaesthesiology, University Hospital Carl-Gustav-Carus, Dresden, Germany.
authors: M
authors: M
authors: Hübler
authors: R J
authors: RJ
authors: Litz
authors: K H
authors: KH
authors: Sengebusch
authors: I
authors: I
authors: Kreinecker
authors: M D
authors: MD
authors: Frank
authors: O W
authors: OW
authors: Hakenberg
authors: D M
authors: DM
authors: Albrecht
mesh_terms: 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
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004338:Drug Combinations; D019999:Pharmaceutical Solutions; D002245:Carbon Dioxide; D000077212:Ropivacaine; D017409:Sufentanil; D002045:Bupivacaine