Continuous epidural infusion for postoperative mechanical ventilation

We evaluated in analgesic and sedative effects of continuous epidural infusion of two analgesic regimens in ventilated patients following esophagectomy. Forty-six patients, divided into two treatment groups, received postoperative continuous epidural infusion of morphine, or that of a combination of bupivacaine and morphine. Assessments were made with the following indices: pain relief score, somnolence score, patient ventilator coordination score, and the number of supplemental administrations of analgesics and sedatives. No significant differences occurred in somnolence scores or patient ventilator coordination scores between the two groups, which revealed satisfactory sedation for mechanical ventilation. Patients receiving the combination of bupivacaine and morphine had significantly less pain postoperatively, requiring a smaller number of supplemental administrations of analgesics and sedatives ( P < 0.05). It is concluded that: 1) continuous epidural infusion of analgesics gives potent analgesia and sedation of ventilated patients following esophagectomy; 2) the combination of bupivacaine and morphine gives pain relief superior to morphine alone.