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Comparison of the effects of continuous intrapleural vs epidural administration of 0.5 % bupivacaine on pain, metabolic response and pulmonary function following cholecystectomy
Author(s) -
Scott N. B.,
Mogensen T.,
Bigler D.,
Kehlet H.
Publication year - 1989
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1989.tb02961.x
Subject(s) - medicine , bupivacaine , anesthesia , visual analogue scale , bolus (digestion) , vital capacity , pulmonary function testing , cholecystectomy , fight or flight response , surgery , lung function , lung , biochemistry , chemistry , diffusing capacity , gene
Twenty patients undergoing elective cholecystectomy were prospectively randomised to receive either intrapleural (bolus 20 ml followed by 10 ml/h) or thoracic epidural (bolus 9 ml followed by 5 ml/h) bupivacaine 0.5% for 8 h postoperatively to assess the effect of these two techniques on pain, pulmonary function and the surgical stress response. As assessed by the visual analogue scale (VAS), both groups received good but not total pain relief. Both groups had a 50% reduction in forced expiratory volume (FEV 1 ), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) after operation, and there was no observed effect on the stress response as measured by plasma glucose and cortisol. It is concluded that while both techniques provide good analgesia, the degree and extent of nerve blockade are not sufficient to affect the afferent neurogenic stimuli responsible for the observed effects on pulmonary function and the stress response.