title: [Epidural infusion of low dose bupivacaine after combined spinal-epidural anesthesia using needle through needle method provided no analgesic effect on postoperative pain after caesarian section].
abstract: BACKGROUND
  In order to evaluate the analgesic efficacy of low dose epidural bupivacaine infusion with and without morphine after caesarean section we performed combined spinal-epidural anesthesia (CSEA) using needle through needle method. Three different epidural analgesic regimens were compared retrospectively.
  
  
  METHODS
  The number of analgesic use during 24 hours after operation was compared. Patients were categorized into three groups; group N : intraoperative bolus epidural morphine (2.5 mg) alone, group L : bolus morphine (2.5 mg) plus epidural bupivacaine infusion (32 ml of 0.2% bupivacaine) at a rate of 2.1 ml x hr(-1), group M : bolus morphine (2.4 mg) plus epidural bupivacaine-morphine (33 ml of 0.2% bupivacaine containing morphine 2.3 mg) infusion at a rate of 2.1 ml x hr(-1). Used analgesics included pentazocine 15 mg i.m., diclofenac 25 mg suppo. and loxoprofen 60 mg p.o..
  
  
  RESULTS
  The mean number of analgesic use during the first 24 hours in group M (0.29 +/- 0.46) was significantly smaller than those of group N (0.97 +/- 0.91) and group L (0.84 +/- 0.95). Percentage of patients requiring no analgesic during the first 24 hours was significantly less in group M (70.8%) than in group N (33.4%) and group L (42.1%).
  
  
  CONCLUSIONS
  A 2.1 ml x hr(-1) infusion of epidural bupivacaine has no analgesic effect after caesarean section under CSEA using NTN method.
authors.affiliation: Department of Anesthesia, Miyazaki Shigun Ishikai Hospital, Miyazaki 880-0834.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katsuki
authors.forename: Nami
authors.initials: N
authors.lastname: Hidaka
authors.forename: Ayumi
authors.initials: A
authors.lastname: Kunitake
authors.forename: Shingo
authors.initials: S
authors.lastname: Tateyama
authors.forename: Mayumi
authors.initials: M
authors.lastname: Takasaki
mesh_terms: D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D009339:Needles; D010149:Postoperative Pain / Q000188:drug therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine