title: A trial of pre-emptive analgesia. Influence of timing of peroperative alfentanil on postoperative pain and analgesic requirements.
abstract: The influence of timing of administration of peroperative alfentanil on pain and analgesic requirements after surgery was studied in 60 patients undergoing total abdominal hysterectomy with or without bilateral salpingo-oophorectomy. Thirty patients received alfentanil 7.5 micrograms.kg-1 on induction of anaesthesia, followed by alfentanil 7.5 micrograms.kg-1 90 s before surgical incision (group A). Thirty control patients received alfentanil 15 micrograms.kg-1, 10 min after abdominal incision (group B). In addition, 10 min after surgical incision both groups received morphine 0.2 mg.kg-1, given over a 10 min period. The visual analogue scores (median, interquartile range) for pain 24 h after operation were 28.5 mm (11.25-47.0) in group A and 21.0 mm (10.5-47.5) in group B, p = 0.76. There were no differences in visual analogue scores at intermediate times. Morphine consumption in the first 24 h after surgery (median, interquartile range) was 53.5 mg (37.25-60.0) in group A and 52.0 mg (39.75-71.0) in group B, p = 0.52. We conclude that postoperative morphine consumption and pain scores are no different when alfentanil 15 micrograms.kg-1 is given before or after skin incision for abdominal hysterectomy.
authors.affiliation: Department of Anaesthesia, Stobhill General Hospital, Glasgow.
authors.forename: M
authors.initials: M
authors.lastname: Mansfield
authors.forename: R
authors.initials: R
authors.lastname: Meikle
authors.forename: C
authors.initials: C
authors.lastname: Miller
mesh_terms: D000328:Adult; D015760:Alfentanil / Q000008:administration & dosage*; D000698:Analgesia / Q000379:methods*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010149:Postoperative Pain / Q000517:prevention & control*; D011184:Postoperative Period; D016037:Single-Blind Method
chemical_list: D015760:Alfentanil; D009020:Morphine