title: Pre-emptive analgesia from intravenous administration of opioids. No effect with alfentanil.
abstract: Forty patients undergoing total abdominal hysterectomy were randomly allocated to receive either 40 micrograms.kg-1 of alfentanil on induction of anaesthesia or 40 micrograms.kg-1 of alfentanil after the skin incision. Postoperative pain relief was provided with morphine from a patient-controlled analgesia system. The amount of morphine consumed in the operating theatre, while in recovery and for the first 24 h postoperatively was recorded. Pain scores were assessed at 24 h using a visual analogue scale. There were no differences found between the two groups for morphine consumption but the 'pre-emptive' group had significantly higher pain scores at rest. We conclude that there is no clinically useful pre-emptive analgesic effect with this dose of alfentanil and that therefore systemic opioid premedication is unlikely to decrease postoperative analgesic requirements through the mechanism of pre-emptive analgesia.
authors.affiliation: Department of Anaesthetics, York District Hospital.
authors.forename: R J
authors.initials: RJ
authors.lastname: Wilson
authors.forename: S
authors.initials: S
authors.lastname: Leith
authors.forename: I J
authors.initials: IJ
authors.lastname: Jackson
authors.forename: D
authors.initials: D
authors.lastname: Hunter
mesh_terms: D000328:Adult; D015760:Alfentanil / Q000008:administration & dosage*; D000698:Analgesia / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007275:Injections, Intravenous; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011229:Preanesthetic Medication
chemical_list: D015760:Alfentanil; D009020:Morphine