Continuous Epidural Analgesia in Prostatectomy: Comparison of Bupivacaine With and Without Adrenaline

Epidural analgesia is well‐suited for lower abdominal surgery, especially on patients of advanced age groups. Bupivacaine (Marcainr̀) has gradually become a well‐established analgesic which is well‐suited for epidural analgesia, being distinguished by its potency and prolonged action. As a rule, it has been recommended to add adrenaline to the analgesic solution to obtain the maximum period of action and to keep the plasma level of the analgesic as low as possible. However, since the addition of adrenaline per se involves a risk of untoward reactions, we were interested in investigating whether a clinical trial could demonstrate any difference between bupivacaine 0.5% with and without the addition of adrenaline. The trial was carried out double‐blind in 50 consecutive prostatectomies performed under continuous epidural analgesia. The catheter was left in the epidural space for the first 24 postoperative hours, and during this period, the patients were kept free of pain by injection of the analgesic solution through the catheter as required. In this material, there was no difference with respect to effect, extent or duration of analgesia between the two groups.