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In order to discuss the safty of epidural anesthesia with continuous infusion method, therelationship between serum concentration of mepivacaine and time laps during continuousepidural infusion was observed in 44 patients who underwent laparotomy.Continuous epidural infusion was started at the rate of ko (mg/hr) at τ (min) after initialepidural injection with about 200 mg mepivacaine HC1. Patients were divided into fourgroups by τ/k0 as follows: 20/100, 20/120, 30/150, and 60/150.Significant difference of serum mepivacaine concentration in four groups during continuousepidural infusion was not observed. Mean serum mepivacaine concentration of each groupat 4-5 hr after initial injection (3-4 hr after a start of continuous infusion) was about 5-6, μg/ml. Thus it was suggested that serum concentration of mepivacaine was at the safety levelduring surgery for 5 hr with continuous epidural infusion of 100-150 mg/hr mepivacaine HC1.In the group where τ=60, additional bolus epidural injection was necessary for half ofthe patients before and after a start of continuous epidural infusion. Therefore, continuousinfusion ought to be started by 60 min after initial injection (200 mg) in our methods.

Serum concentration of mepivacaine during epidural anesthesia by continuous infusion method.