Open AccessLow-Dose Bupivacaine Does Not Improve Postoperative Epidural Fentanyl Analgesia in Orthopedic Patients
Author(s) -
Neal H. Badner,
Eleanor Reimer,
Wendy E. Komar,
Carol A. Moote
Publication year - 1991
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/00000539-199103000-00010
Subject(s) - medicine , fentanyl , bupivacaine , anesthesia , nausea , vomiting , orthopedic surgery , local anesthetic , surgery
Epidural infusions of 10 micrograms/mL fentanyl combined with low-dose bupivacaine (0.1%) were compared with epidural infusions of fentanyl alone for postoperative analgesia after total knee joint replacement. There were no detectable differences between the two groups in analgesia (visual analogue scale ranging between 15 and 40 mm), infusion rates (which averaged 7-9 mL/h), or serum fentanyl levels (which reached 1-2 ng/mL). The incidence of side effects, including nausea, vomiting, and pruritus, was also similar. Of the patients receiving fentanyl and low-dose bupivacaine, one developed a transient unilateral motor and sensory loss, and one developed significant hypotension and respiratory depression. The addition of low-dose bupivacaine does not improve epidural fentanyl infusion analgesia after knee surgery and may increase morbidity.