Epidural fentanyl in the management of postoperative pain

Epidural fentanyl (Sublimaze; Janssen) in the management of postoperative pain, with particular attention to efficacy and safety, was investigated. A treatment group (group 1) of 31 patients and a control group (group 2) of 30 patients were used. Group 1 received epidural fentanyl 100 micrograms postoperatively, while in the control group pain was treated with intramuscular pethidine 1.5 mg/kg 4-6-hourly as required during the 11 hours in the recovery room. Epidural fentanyl started working within 20 minutes and provided excellent analgesia for 8 hours or more postoperatively, comparable to repeated doses of intramuscular pethidine. Of the patients in group 1 13% experienced tolerable pruritus and the incidence of nausea and vomiting was small relative to that recorded in group 2.