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bupivacaine + fentanyl + epinephrine is a combination analgesic regimen administered via the epidural route for the management of postoperative pain. This specific formulation was utilized in a Phase 4 clinical trial (NCT01510106) led by Lena Nilsson to evaluate recovery outcomes in patients undergoing open surgery for gynecological cancer. The combination leverages three distinct mechanisms: bupivacaine, a local anesthetic, blocks voltage-gated sodium channels to inhibit nerve conduction; fentanyl, a potent opioid, acts as an agonist at mu-opioid receptors to provide regional and systemic analgesia; and epinephrine, an alpha- and beta-adrenergic agonist, serves as a vasoconstrictor to prolong the local effect of the anesthetic and reduce systemic absorption. The study compared this epidural regimen against intrathecal analgesia to assess differences in hospital length of stay and patient quality of life.
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