Experience of intermittent epidural analgesia for open liver resection

Abstract

There were some reports regarding intermittent method of epidural analgesia would be better in terms of postoperative analgesia with the obstetric analgesia for labors. In this study, the main outcome was to investigate the appropriate dosage of intermittent bolus injection from epidural block (0.2%ropivacaine 200mL+fentanyl 200-400μg/kg). The definition of “Appropriate” was we had no side effects such as neurologic complication such as numbing and hypotension, and to keep the patient’s good pain control controlled below resting Numerous Rating Scale (NRS) three until 24 hours after surgery (ICU periods). This study started from 2ml6ml/60 minutes (minimum dose) according to our protocol. In 2ml protocol, one patient cleared our protocol, however two patients couldn’t clear in terms of NRS. In 3ml protocol, we could keep the good pain control based on the definition of “effectiveness” (NRS, bolus request, the necessity of increased pain analgegics and no deleterious events). 3mL of intermittent epidural contrast for the open hepatectomy was identified by our clinical study in order to control the postoperative pain. The results of our study might contribute to future research regarding intermittent epidural administration, as well as provide patients with more excellent analgesia. *Correspondence to: Takashi Matsusaki, Department of Anesthesiology and Resuscitology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan, E-mail: matusakik@ybb.ne.jp