[Effectiveness of extrameningeally administered opioids in patients with aortic prosthesis]

The examination was carried out in 60 men at the age of 56 to 78 (mean age 65.3 years) treated by suturing of vascular prosthesis due to aneurysm of abdominal part of aorta, in which postoperative analgesia was done with the use of bupivacaine with opioids administered extradurally. Patients were divided into two groups consisting of 30 individuals each. In group I, patients were given 0.25% bupivacaine with phentanyl, while in group II--bupivacaine appropriate for the need of the patient. Postoperative analgesia, in particular stages was complete in 75% of patients of group II and 63% of group I at twenty-four hour long maintenance of the initial dose of analgesics. Twenty-four hour long dose of bupivacaine to 210+/-20.5 mg in group I and 145+/-11.5 mg, while morphine 5.1+/-1.2 mg. Fluctuation of the chosen haemodynamic and gasometric parameters were of no clinical importance. 7 patients suffered from nausea and vomiting, these patients included 2 patients from group I and in 5 patients from group II. On this basis of results, one may confirm that both methods of analgesia are equally effective, although it was possible to reduce the twenty-four hour long dose of bupivacaine, thus limiting the risk of depressive effect on heart muscle.