title: Comparison of patient-controlled epidural analgesia with patient-controlled intravenous analgesia using pethidine or fentanyl.
abstract: We compared patient-controlled epidural analgesia (PCEA) with patient-controlled intravenous analgesia (PCIA) using pethidine or fentanyl in a randomized, double-blind crossover study of 80 patients after caesarean section. Patients received pethidine by PCEA or PCIA, or fentanyl by PCEA or PCIA, with a crossover of the route of administration at 12h. For pethidine, pain scores were lower with PCEA vs PCIA from 4 to 16h (P < 0.05). Pethidine consumption was lower with PCEA vs PCIA from 12 to 24h (P = 0.0005). Patients preferred PCEA to PCIA (P = 0.015). For fentanyl, pain scores were lower with PCEA vs PCIA at 12h (P = 0.045). Fentanyl consumption was lower with PCEA vs PCIA from 0 to 12h (P = 0.0007). Patients had similar preference for PCEA and PCIA. Pain scores and side-effects were similar between drugs. Plasma pethidine was similar between groups. Plasma fentanyl was higher with PCIA vs PCEA at 12h (P = 0.002). PCEA has advantages over PCIA and pethidine may be the preferred drug.
authors.affiliation: Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: W D
authors.initials: WD
authors.lastname: Ngan Kee
authors.forename: K K
authors.initials: KK
authors.lastname: Lam
authors.forename: P P
authors.initials: PP
authors.lastname: Chen
authors.forename: T
authors.initials: T
authors.lastname: Gin
mesh_terms: D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002585:Cesarean Section; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D006801:Humans; D008614:Meperidine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D010149:Postoperative Pain; D011247:Pregnancy
chemical_list: D000701:Analgesics, Opioid; D008614:Meperidine; D005283:Fentanyl