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Epidural bupivacaine for aortic surgery The effect of dilution on the quality of analgesia

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Twenty patients undergoing elective abdominal aortic aneurysm repair were randomly allocated to two groups and studied for 24 h following surgery. Postoperative analgesia was provided by epidural bupivacaine infusion and intravenous patient-controlled 0.05 mg boluses of alfentanil. One treatment group received 7 ml.h-1 of a 0.25% solution of bupivacaine, the other 25 ml.h-1 of a 0.07% solution. The rate of infusion was thus 17.5 mg.h-1 in both groups. Patients receiving 7 ml.h-1 of epidural infusate required more doses of alfentanil (median 26.5, range 0-50) than the group receiving 25 ml.h-1 of the dilute infusion (median 3.0, range 0–16). It is concluded that 17.5 mg.h-1 of bupivacaine infused into the epidural space produces better analgesia when infused in a volume of 25 ml.h-1 (0.07%) than when given in a volume of 7ml.h-1 of solution (0.25%).

Keywords: Anaesthetic techniques, regional; epidural; Analgesics; alfentanil; Surgery; cardiovascular

Document Type: Research Article


Affiliations: J.M. Slade, BM, BCh, FRCA, Senior Registrar, Department of Anaesthetics, Poole General Hospital, Longfleet Road, Poole, Dorset.

Publication date: January 1, 1994


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