[Patient-controlled analgesia using meperidine in the postoperative period after cholecystectomy. Study of possible complications at 2 different levels of surveillance].
OBJECTIVE
To ascertain the side effects of intravenous meperidine in patient-controlled analgesia under two levels of surveillance: one in the recovery room and one in the hospital's surgical ward.


METHODS
Patient-controlled analgesia with meperidine was made available to 80 patients who had undergone cholecystectomy by laparotomy. Instances of nausea/vomiting, pruritus, urinary retention and technical problems were recorded, as well as arterial gas levels (cooximetry) on the first, third, twelfth and twenty-fourth hours after surgery. We also recorded meperidine consumption and its relationship to side affects.


RESULTS
Side effects were associated with higher consumption of meperidine (437.0 +/- 117.7 mg vs 297.7 +/- 135.9 mg in those experiencing no side effects), with more episodes of PO2 < 70 mmHg and SO2 < 90% on the ward than in the recovery room (24 and 10 as compared to 85 and 30, respectively). Patients presenting adverse side effects were significantly older (76.6 +/- 13.5 vs 58.1 +/- 11.1 years).


CONCLUSIONS
Given that age and higher meperidine consumption were associated with more frequent occurrence of hypoxic episodes, patients should receive greater surveillance on the ward, with oxygen therapy, monitoring of accumulated consumption and caution used with older patients.
Servicio de Anestesiología y Reanimación, Hospital del Noroeste de Murcia.
F
F
López-Soriano
F
F
Rivas-López
D000367:Age Factors; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000451:nursing; D000777:Anesthetics / Q000009:adverse effects; D001007:Anxiety; D002318:Cardiovascular Diseases / Q000139:chemically induced; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000451:nursing / Q000517:prevention & control* / Q000628:therapy; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009846:Oliguria / Q000139:chemically induced; D010102:Oxygen Inhalation Therapy; D010149:Postoperative Pain / Q000188:drug therapy*; D010362:Patients' Rooms; D011182:Postoperative Care / Q000451:nursing*; D011183:Postoperative Complications / Q000139:chemically induced* / Q000451:nursing / Q000517:prevention & control / Q000628:therapy; D011997:Recovery Room
D000777:Anesthetics; D008614:Meperidine
Analgesia controlada por el paciente con meperidina en el postoperatorio de colecistectomía. Estudio de posibles complicaciones a dos niveles de vigilancia diferentes.