Orthostatic Hypotension During Postoperative Continuous Thoracic Epidural Bupivacaine-Morphine in Patients Undergoing Abdominal Surgery

Fifty patients undergoing colonic surgery received combined thoracic epidural and general anesthesia followed by continuous epidural bupivacaine 0.25% and morphine 0.05 mg/mL, 4 mL/h, for 96 h postoperatively plus oral tenoxicam 20 mg daily. Heart rate (HR) and arterial blood pressure (BP) were measured at supine rest, during orthostatic stress, and after walking prior to and 24, 48, and 72 h after surgery. Systolic BP at rest was significantly lower 24 h and 48 h postoperatively compared to preoperatively (P or=to0.3; HR, P > 0.34) and 12 vs 8 patients (P = 0.45) experienced a systolic BP decrease > 20 mm Hg post- versus preoperatively. After walking, systolic BP was significantly lower postoperatively compared with preoperatively (P