Epidural patient-controlled analgesia (PCA): an alternative to continuous epidural infusions.
In a clinical study involving 16 surgical patients receiving epidural hydromorphone for postoperative analgesia, we compared the use of a continuous infusion technique to an intermittent bolus technique (involving the use of a PCA device). Although comparable analgesia was achieved in the 2 treatment groups during the 48 h study period, the hydromorphone usage (mean value +/- S.D.) was significantly higher in the continuous infusion group (10.2 +/- 3.6 mg vs. 4.6 +/- 2.2 mg in the intermittent bolus group). In spite of this difference in the analgesic dosage requirement, the side effect profile was similar for the 2 groups. Further studies are needed to confirm this observation and to determine the implications with respect to postoperative recovery.
Marlowe
Steven
S
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305 U.S.A. Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110 U.S.A.
Engstrom
Ray
R
White
Paul F
PF
D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy*; D011183:Postoperative Complications; D012646:Self Administration / Q000379:methods*
D009020:Morphine