We investigated changes in plasma concentration of lidocaine during continuous epidural anesthesia in 21 patients undergoing hepatectomy. According to the extent of hepatectomy, patients were assigned into one of the three groups: partial resection group, lobectomy group, and extended lobectomy group. Lidocaine 2.0 mg.kg-1 with 1: 200,000 epinephrine was epidurally administered in a bolus followed by continuous infusion of lidocaine at the rate of 1.5mg.kg-1.h-1. Plasma lidocaine concentration in the extended lobectomy group showed a significantly higher value than those of other two groups (P < 0.05). Plasma lidocaine was detected in the extended lobectomy group at 12 hs after the surgery, but not in the other two groups. Furthermore we investigated the effects of prostaglandin E1 infusion in 7 patients undergoing extended lobectomy. Plasma lidocaine concentration was not increased in this group. In conclusion, we recommend caution regarding the dose of lidocaine administered for epidural anesthesia during hepatectomy; PGE1 infusion appears to be safe in patients undergoing extended hepatectomy.
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