title: Addition of adrenaline to pethidine for epidural analgesia after caesarean section.
abstract: We have investigated the addition of adrenaline to epidural pethidine for postoperative analgesia in 40 patients after Caesarean section. In a randomised, double-blind study, patients received pethidine 25 mg with adrenaline 50 micrograms (adrenaline group, n = 20) or pethidine 25 mg without adrenaline (plain group, n = 18) epidurally at the first request for postoperative analgesia. The median duration of analgesia was longer in the adrenaline group (196 min; IQR 123-286) compared with the plain group (96 min; IQR 43-113; p = 0.002) and plasma concentrations of pethidine in the first 30 min after injection were lower in the adrenaline group (p = 0.003). Visual analogue scale pain scores in the first 30 min after injection and onset of analgesia, defined by the time for pain scores to decrease by 50%, were similar between groups. Addition of adrenaline to epidural pethidine has advantages for analgesia after Caesarean section.
authors.affiliation: Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, People's Republic of China.
authors.forename: W D
authors.initials: WD
authors.lastname: Ngan Kee
authors.forename: M L
authors.initials: ML
authors.lastname: Ma
authors.forename: K S
authors.initials: KS
authors.lastname: Khaw
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D000701:Analgesics, Opioid; D002585:Cesarean Section; D004311:Double-Blind Method; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008614:Meperidine; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011247:Pregnancy; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D014662:Vasoconstrictor Agents; D008614:Meperidine; D004837:Epinephrine