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The effects of 0.5% bupivacaine-CO2 and bupivacaine-HCl were tested in a prospective randomised trial on 16 patients who underwent extracorporal shock wave lithotripsy (ESWL) with epidural analgesia. A shorter time of onset of analgesia (3.75 +/- 0.51 min) and a faster distribution of analgesia were noted with bupivacaine-CO2. Hypoalgesic regions were not registered with bupivacaine-CO2 nor with bupivacaine-HCl under shock wave treatment. About thirty minutes after application of either substance a level 1 block according to Bromage was noted, which was not desirable during positioning of the patient on the hydraulic lithotriptor chair. However, toxic blood levels were not reached in either group of patients to any extent.
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