Why the study?
Does continuous thoracic epidural injection of 1.0% bupivacaine provide effective and safe pain relief after upper abdominal surgery?
Does continuous thoracic epidural injection of 1.0% bupivacaine provide effective and safe pain relief after upper abdominal surgery?
Continuous thoracic epidural injection of 1.0% bupivacaine is not recommended for pain relief after upper abdominal surgery due to tachyphylaxis and adverse effects like urinary retention.
Case report cautions against continuous 1% bupivacaine thoracic epidural after upper abdominal surgery; leaves open optimal regimens for controlled trials.
Sixteen patients were given thoracic epidural analgesia at the T5-T6 level with 2 ml of 1.0% bupivacaine solution plain for pain relief after upper abdominal surgery. In 13 cases the analgesia was prolonged by continuous injection of 1.0% bupivacaine for 24 or 48 h. Onset time and segmental spread of the analgesia are presented as well as segmental spread, intensity of the blockade, and peak expiratory flow rates during prolongation. Signs of tachyphylaxis were noticed, and also signs of accumulation of bupivacaine in plasma. A high incidence of urinary retention occurred. The method is not considered to be ideal for pain relief after upper abdominal surgery.
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Renck et al. (1976) studied this question.
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