Epidural analgesia following thoracic surgery. A review of two years' experience.

The use of thoracic epidurals for postoperative pain relief in 58 patients following thoracic surgery is reviewed. Epidural catheters were inserted at the end of the operative procedure and it was planned that analgesia was to be maintained with a continuous infusion of bupivacaine. In those patients with evidence of successful neurological blockade there was a high incidence of adverse effects. Hypotension occurred in nearly 80% of patients and inadequate analgesia necessitating intramuscular opiates in 30%. The results suggest that the method adopted is unsuitable for some patients who have undergone major pulmonary surgery, although it has proved a useful adjuvant for pain relief in patients who have had other intrathoracic operations.