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British Journal of Anaesthesia, 1988, Vol. 60, No. 5 515-519
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

UNPREDICTABILITY OF REGRESSION OF ANALGESIA DURING THE CONTINUOUS POSTOPERATIVE EXTRADURAL INFUSION OF BUPIVACAINE

T. MOGENSEN, M.D., N.-C. HJORTSØ, M.D., D. BIGLER, M.D., C. LUND, M.D. and H. KEHLET, M.D., PH.D.

Department of Anaesthesia, Hvidovre Hospital Copenhagen, Denmark
Department of Surgical Gastroenterology, Hvidovre Hospital Copenhagen, Denmark

Address for correspondence: Department of Anaesthesia, Hvidovre Hospital, DK-2650 Hvidovre, Denmark

Twenty-four otherwise healthy patients scheduled for elective major abdominal surgery received general anaesthesia plus lumbar extradural analgesia. A loading dose of 0.5% plain bupivacaine was given to produce sensory analgesia (pin prick) from T4 to S5 and followed by a continuous infusion of 0.5% plain bupivacaine 8 ml h–1. Pain, scored on a 5-point scale, and sensory analgesia were assessed hourly for 16 h after skin incision. If sensory analgesia decreased by more than 5 segments from its preoperative level, or if the pain score reached 2 (moderate pain), the patients were removed from the study, and pain was treated otherwise. Only three patients maintained their initial levels of sensory analgesia and a pain score of less than 2. In the remaining patients sensory analgesia decreased at least 5 segments or pain score reached 2 between 4 and 16h after skin incision. We found a weak correlation between increasing age and the duration of sensory analgesia (r=0.46, P<0.05), but no significant correlations between duration of sensory analgesia and sex, weight, height, body surface area, serum albumin concentration, duration or site of operation.


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