Patient controlled analgesic therapy in the early postoperative period.
Fourteen patients with postoperative pain were allowed to self-administer preset doses of pethidine intravenously via a logic-controlled motor syringe. Plasma samples were collected during anaesthesia and the postoperative self-administration period, and the concentrations of pethidine and nor-pethidine were determined. Separate single-dose studies in eight patients yielded pharmacokinetic parameters which made possible computer simulations of continuous plasma concentration curves for the anaesthesia and postoperative self-administration period. The consumption of pethidine showed great interindividual variations with a mean consumption for the entire group of 26 mg per hour. The patients established steady-state plasma concentrations with far less than the maximum amount of pethidine allowed. The mean measured plasma concentration of pethidine which provided adequate analgesia was 738 +/- 149 ng/ml. Simulated and measured plasma concentrations were in close agreement. The individual mean drug consumption per hour during self-administration correlated closely with the individual elimination rate of pethidine. No serious side effects were observed. Thus, patient-controlled analgesic therapy offers an individualized analgesic supply to meet an analgesic demand which is governed by each patient's appreciation of pain.
D000328:Adult; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007813:Laparotomy; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D010313:Partial Pressure; D011184:Postoperative Period; D012646:Self Administration; D013594:Syringes
D008614:Meperidine