Abstract

Epidural opiates alone do not provide sufficient anesthesia for most surgical procedures. Combined with local anesthetics, however, they are valuable in treating postoperative and labor pain. Two groups of patients were compared (n = 21) who underwent extracorporeal shock wave lithotripsy (ESWL). One group was given a local anesthetic, lidocaine, and the other was given a local anesthetic-opiate combination, bupivacaine-fentanyl. In each group, adequate levels of analgesia were obtained. The bupivacaine-fentanyl mixture produced significantly less motor block. Its disadvantages were a longer onset time and occasional itching. This small series confirms the clinical value of a low-dose epidural bupivacaine-fentanyl mixture as an alternative to lidocaine for use in ESWL, and suggests that greater use be made of this mixture.