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Patient-controlled analgesia with extradural morphine or pethidine
S Sjöström1, D Hartvig, A Tamsen
1Department of Anaesthesiology, University Hospital, Uppsala, Sweden.
British Journal of Anaesthesia
|March 1, 1988
Summary
Patient-controlled analgesia (PCA) using extradural morphine or pethidine provided excellent pain relief after abdominal surgery. However, large variations in patient consumption make standard dosing impossible.
Area of Science:
- Anesthesiology
- Pharmacology
- Pain Management
Background:
- Postoperative pain management is crucial for patient recovery.
- Extradural patient-controlled analgesia (PCA) offers a method for self-administered pain relief.
- Morphine and pethidine are commonly used opioids for analgesia.
Purpose of the Study:
- To compare the efficacy and safety of extradural morphine versus pethidine via PCA for postoperative pain control.
- To determine the equianalgesic dose ratio between extradural morphine and pethidine.
- To assess opioid consumption patterns and plasma concentrations during PCA.
Main Methods:
- Two groups of patients received extradural PCA with either morphine (1 mg bolus) or pethidine (20 mg bolus) after abdominal surgery.
- Patients self-administered analgesia for approximately 16 hours.
- Pain relief, opioid consumption, and plasma concentrations were monitored.
Main Results:
- Excellent pain relief was achieved in most patients, with no significant qualitative difference between morphine and pethidine groups.
- No clinical respiratory depression was observed.
- The equianalgesic dose ratio was approximately 1:35 (morphine:pethidine), with significant inter-individual variation in consumption.
Conclusions:
- Extradural PCA with morphine or pethidine is effective for postoperative pain management after abdominal surgery.
- Significant variability in patient opioid requirements precludes the recommendation of standard doses.
- Further research is needed to optimize dosing strategies for extradural PCA.