Comparison of patient-controlled analgesia with and without a background infusion after lower abdominal surgery in children.
Forty children aged 6-12 yr undergoing appendicectomy were allocated randomly to receive postoperative i.v. morphine by a patient-controlled analgesia (PCA) system (bolus dose 20 micrograms kg-1 with a lockout interval of 5 min) or the same PCA with a background infusion of morphine 20 micrograms kg-1 h-1. Patients breathed air and oxygen saturation was monitored by continuous pulse oximetry. Scores for pain, sedation and nausea were recorded hourly. Patients with PCA + background infusion received significantly more morphine than those with PCA only. Both groups self-administered similar amounts of morphine using the PCA machine. There were no significant differences in the pain scores of the two groups. Patients with PCA+background infusion suffered more nausea (P < 0.01), more sedation (P < 0.05) and hypoxaemia (P < 0.001) than those with PCA only. They also had a better sleep pattern than those with PCA only.
Doyle
E
E
Department of Anaesthesia, Royal Hospital for Sick Children, Yorkhill, Glasgow.
Robinson
D
D
Morton
N S
NS
D016058:Analgesia, Patient-Controlled; D001062:Appendectomy; D002648:Child; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009325:Nausea / Q000139:chemically induced; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
D009020:Morphine; D010100:Oxygen