title: A comparison of opioid solutions for patient-controlled epidural analgesia.
abstract: Sixty patients took part in a randomised, double-blind study to compare the analgesic and side effects of three opioid-containing solutions for patient-controlled epidural analgesia following abdominal surgery. Patients in group 1 received a solution containing bupivacaine 0.125% with fentanyl 10 micrograms.ml-1, group 2 bupivacaine 0.125% with diamorphine 125 micrograms.ml-1, group 3 pethidine 2.5 mg.ml-1. All groups received 4 ml.h-1 background infusion and 3 ml boluses every 20 min if necessary. There were no significant differences between the groups in visual analogue scale pain scores (p = 0.537) or volumes of solution used at 24 h (p = 0.351) or 48 h (p = 0.105). Motor block was significantly higher in group 2 (p < 0.004) and pruritus occurred significantly less in group 3 (p < 0.05). We conclude that these three solutions produce equivalent analgesia but that pethidine 2.5 mg.ml-1 may be associated with fewer side effects.
authors.affiliation: Department of Anaesthetics, University Hospital of Wales, Health Park, Cardiff.
authors.forename: A J
authors.initials: AJ
authors.lastname: Smith
authors.forename: T K
authors.initials: TK
authors.lastname: Haynes
authors.forename: D E
authors.initials: DE
authors.lastname: Roberts
authors.forename: M
authors.initials: M
authors.lastname: Harmer
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D003932:Heroin / Q000008:administration & dosage; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008614:Meperidine / Q000008:administration & dosage; D008875:Middle Aged; D010147:Pain Measurement; D011537:Pruritus / Q000139:chemically induced; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D003932:Heroin; D008614:Meperidine; D005283:Fentanyl; D002045:Bupivacaine