[Multiorgan dysfunction syndrome (MODS) caused by long bone fractures in young persons]

In a prospective open study, the effect of continuous epidural analgesia by the 0.5% bupivacaine-methadone mixture on the perfusion in the lower extremities was examined in a group of 34 patients (mean age 31.25-1.52 years). The patients were undergoing a standard intensive care treatment. The minimum analgetic dose was determined by means of an analogous-visual ten-point scale, and the minimum perfusion dose (MBD) by measuring the foot temperature on the injured side with electronic thermometer Genius 3000 (Sherwood, USA). Immediately, following the injury, the foot temperature on the involved side measured 27.40-2.20 (25.20-31.30) degrees C. The temperature differences between the injured and healthy foot were 5.92-2.19 degrees C, p = 0.0000. Forty minutes after the induction of epidural analgesia, the temperature of the injured foot increased to 32.44-1.75 degrees C, p = 0.0000. After 24 hours, it measured 32.44-1.27 degrees C, i.e. almost the same as in the healthy foot, with the auricle temperature being 36.20-1.62 degrees C. The total dose of methadone during the first 24 hours was 20 mg, and the 0.5% bupivacaine dose was 133.00-48.80 mg/24 hrs.