Abstract
This study was performed to investigate effectiveness of 0.25% or 0.5% bupivacaine HCl which was applied to forty postoperative patients who underwent the upper abdominal surgery with continuous epidural analgesia. Analgesic extent, pain score, blood gas, blood pressure and plasma concentration of bupivacaine were measured. Tip of epidural catheter was placed at the Th7 epidural space in all patients before operation. 0.25% or 0.5% bupivacaine was administered continuously for 48 hours in 20 postoperative patents of two groups. A single dose of 6-7ml with bupivacaine was injected one hour before continuous epidural analgesia started. Continuous epidural infusion was given at the rate of 3.3-4.3ml/hour for 48 hours. The group of 0.5 bupivacaine revealed improved pain score than in 0.25% group. The plasma concentration of 0.5 bupivacaine reached 3.07±0.61μg/ml after 48 hours. This concentration did not exceed toxic dose of 4μg/ml. In this study, we demonstrated that 3.3-4.3ml/hr of 0.5% bupivacaine provided satisfying analgesic effects with better pain score and notoxic plasma concentration and no severe hypotension.
