Hypoxaemia and pain relief after lower abdominal surgery: comparison of extradural and patient-controlled analgesia.
We have examined postoperative pain in patients allocated randomly to receive extradural bolus diamorphine 3.6 mg, extradural infusion of 0.15% bupivacaine with 0.01% diamorphine or patient-controlled i.v. administration of diamorphine at a maximum rate of 1 mg per 5 min, after total abdominal hysterectomy. Extradural infusion analgesia produced the smallest pain scores from 12 to 24 h after surgery (P < 0.05). More patients in the extradural infusion group were moderately hypoxaemic (SpO2 < 90% > 12 min h-1) after operation, compared with the two other groups (P < 0.05). The group using patient-controlled analgesia received more diamorphine and suffered a greater incidence of emetic sequelae (P < 0.05).
Madej
T H
TH
Department of Anaesthesia, York District Hospital.
Wheatley
R G
RG
Jackson
I J
IJ
Hunter
D
D
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D002045:Bupivacaine / Q000009:adverse effects; D005260:Female; D003932:Heroin / Q000009:adverse effects; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced*; D007044:Hysterectomy; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*
D003932:Heroin; D002045:Bupivacaine