COMPLICATIONS RELATED TO THORACIC EPIDURAL ANALGESIA - A PROSPECTIVE-STUDY IN 1071 SURGICAL PATIENTS

In a prospective study, the complications of 1071 patients scheduled f or thoracic epidural catheterization for postoperative analgesia (TEA) were studied. All catheters were inserted preoperatively between segm ent Th 2/3 and Th 11/12 under local anesthesia. Balanced anesthesia wi th endotracheal intubation and TEA were combined. Postoperatively 389 patients (36.9%) were monitored on a normal surgical ward. Buprenorphi ne, 0.15 to 0.3 mg. and if needed bupivacaine 0.375% 3-5 ml h-1 were g iven epidurally. Primary perforation of the dura occurred in 13 patien ts (1.23%). Radicular pain syndromes were observed in six patients (0. 56%). In one patient (0.09%) respiratory depression was seen in close connection with the epidural administration of 0.3 mg buprenorphine. A lthough 116 patients (10.83%) showed one abnormal clotting parameter b ut no clinical signs of hemorrhage, there was no complication related to this group. No persisting neurological sequelae caused by the thora cic epidural catheters were found. In conclusion, continuous TEA with buprenorphine for postoperative pain relief after major abdominal surg ery is a safe method without too high a risk of catheter-related or dr ug-induced complications, even on a normal surgical ward and when one clotting parameter is abnormal.