A comparison of five solutions of local anaesthetics and/or sufentanil forcontinuous, postoperative epidural analgesia after major urological surgery

Background and objective The aim of the present study was to compare and as sess the quality of analgesia, the safety and the side-effects after the us e of a continuous, thoracic epidural infusion of sufentanil (5 mug h(-1)), 0.25% bupivacaine (10 mL h(-1)), 0.2% ropivacaine (10 mt h-l) alone or in c ombination in patients who had undergone major urological surgery. This pro spective, randomized, double-blinded study investigated the efficacy of tho racic epidural infusions after major urological surgery. Methods Patients received a 72-h continuous infusion (10 mL h(-1)) of 0.25% bupivacaine (B), 0.2% ropivacaine (R), 0.25% bupivacaine with 0.5 mug mL(- 1) sufentanil (BS), 0.2% ropivacaine with 0.5 mug mL(-1) sufentanil (RS) or 0.5 mug mL(-1) sufentanil only (S). The analysis included 109 patients. Results The mean visual analogue scale (VAS) scores for pain were highest i n the groups R and S (P<0.001). The PaCO2 values were significantly higher in the groups RS and S (P= 0.003). Motor block occurred more frequently in the groups B and BS than in the other groups (P< 0.001). Sedation, nausea a nd pruritus were more common in the groups that received sufentanil. Conclusions A continuous, epidural infusion with these drugs was safe and e ffective in our patients. The combination of 0.2% ropivacaine plus sufentan il appeared preferable because of the low incidence of motor block.