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Two indirect arterial pressure monitors, the Finapres and the Accutorr, were investigated and compared with the direct measurement of intra-arterial pressure. Pressures in patients in a variety of circulatory states were measured and analysed in relation to two types of random error: first, the "intra-individual standard error" (within one session of measurement) and second, the "inter-individual standard error" (between sessions). (This distinction is important, since in routine monitoring of arterial pressure one is usually dealing with the first type of error only.) This study showed that sudden changes in pressure were closely followed by the Finapres. A pressure reading of the Accutorr takes about 15-20 s, meaning that, within this period, variations will not be observed. The accuracy or reproducibility of each method, as expressed in intra-individual variance, diminished in the order Intra-Arterial-Line, Finapres, Accutorr. The inter-individual variation decreased in the order Intra-Arterial-Line, Accutorr, Finapres. Most of the inter-individual variance of the Finapres is probably real because of the more peripheral position of its cuff. A correlation between malfunctioning of the Finapres and vasoconstriction or hypothermia of the finger could not be demonstrated.

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Analgesia with epidural bupivacaine, sufentanil or the combination was studied in 50 patients who had undergone thoracotomy. During operation all patients received an initial dose of bupivacaine 0.5% with adrenaline 5 micrograms.ml-1 (5-10 ml) by thoracic epidural catheter. One hour later the patients were divided into three groups: the bupivacaine group (bupivacaine 0.125%), the sufentanil group (50 micrograms sufentanil in 60 ml normal saline) and the combination group (50 micrograms sufentanil in 60 ml bupivacaine 0.125%). Analgesia in the three groups was provided by a continuous epidural infusion (5-10 ml.h-1) for 3 days. The mean dose of bupivacaine was significantly higher (P less than 0.05) in the bupivacaine group (12.07 mg.h-1 (s.e.mean 0.97 mg.h-1)), compared with the combination group (9.82 mg.h-1 (s.e.mean 0.43 mg.h-1)). The mean dose of sufentanil in the sufentanil group was similar to the combination group (6.37 micrograms.h-1 (s.e.mean 0.23 micrograms.h-1) and 6.52 micrograms.h-1 (s.e.mean 0.28 micrograms.h-1), respectively. The pain scores on the inverse visual analogue scale of most patients in the bupivacaine group were unacceptably low. The sufentanil group had much better pain scores, but on exercise these patients experienced more pain than the combination group. The combination group had, overall, better pain scores. In the combination group, there were better respiratory results.