Postoperative pressure sores after epidural anaesthesia

Case reports

Case 1—A 52 year old woman weighing 42 kg had carcinoma of the vulva. She was otherwise fit and active. She smoked 20 cigarettes a day. She had a radical vulvectomy and bilateral inguinal lymphadenectomy under combined general and epidural anaesthesia. She was given 20 ml of 0.25% bupivacaine for epidural anaesthesia. To prevent pressure sores, the operating table was covered with silicon jelly pads. Surgery lasted about three hours. The patient was supine for the first 90 minutes and in the lithotomy position thereafter. Her preoperative blood pressure was 120/70 mm Hg. During surgery her systolic blood pressure varied between 85 and 90 mm Hg and her general condition was stable. She received a continuous epidural infusion of plain 0.15% bupivacaine for postoperative analgesia. She remained free of pain and was comfortable. Her systolic blood pressure varied between 75 and 85 mm Hg. She was unable …