Continuous epidural infusion of fentanyl for postoperative analgesia

A continuous epidural infusion of fentanyl was used for control of postoperative pain in a series of 30 patients who had received an epidural anaesthetic for general surgical procedures. Fentanyl was originally administered at a maximal rate of 50 micrograms/hr but later reduced to 25 micrograms/hour or less. Satisfactory analgesia was provided in 24 patients, who required no other form of analgesia whatsoever. Three patients derived significant analgesia from the infusion, but did require occasional small supplementary doses of opiates. Three patients derived little or no benefit from the procedure. The only noticeable side effect was nausea and vomiting, which was less of a feature with the weaker solution. The method was used on general surgical wards with no extra demands being made on nursing staff. Many nursing procedures and physiotherapy could be carried out more conveniently than usual in the postoperative period.