POSTOPERATIVE EPIDURAL INFUSION OF A MIXTURE OF BUPIVACAINE 0.2-PERCENT WITH FENTANYL FOR UPPER ABDOMINAL-SURGERY - A COMPARISON OF THORACIC AND LUMBAR ROUTES

Thirty-three patients who had undergone elective open cholecystectomy were studied in a prospective, randomised comparison of thoracic (n = 17) and lumbar (n = 16) epidural routes of administration of a mixture of bupivacaine 0.2% with fentanyl 10 mu.ml(-1) for postoperative pain . Pain relief, cardiovascular stability, respiratory rate and side eff ects were assessed by a 'blinded' observer at specific times in the 24 h study period. The thoracic epidural route proved significantly more reliable than the lumbar and provided effective analgesia in all pati ents (p < 0.05). This was not accompanied by significant hypotension o r respiratory depression. The incidence of side effects attributable t o use of the lumbar epidural route was significantly higher than with the thoracic route (p < 0.05). This study supports the use of the thor acic epidural route for postoperative pain management after upper abdo minal surgery.