title: The effect of the addition of adrenaline to pethidine for patient-controlled epidural analgesia after caesarean section.
abstract: We have investigated the addition of adrenaline to pethidine for patient-controlled epidural analgesia after elective Caesarean section. In a randomised, double-blind study, patients received patient-controlled epidural analgesia for 24 h using pethidine 5 mg.ml-1 with adrenaline 5 micrograms.ml-1 (adrenaline group, n = 40) or pethidine 5 mg.ml-1 without adrenaline (plain group, n = 38). Visual analogue scale pain scores at rest and on coughing measured 2 h, 6 h and 24 h after surgery were similar between the two groups. There was a trend towards lower mean total consumption of pethidine in the adrenaline group (231.5 mg; SD 140.5 mg) compared with the plain group (289.5 mg; SD 139.5 mg; p = 0.071). Patients in the adrenaline group had higher visual analogue scale scores for nausea at 2 h and 24 h and higher scores for pruritus at 2 h compared with the plain group. Addition of adrenaline to pethidine for patient-controlled epidural analgesia does not appear to have significant clinical advantages.
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: K S
authors.initials: KS
authors.lastname: Khaw
authors.forename: M L
authors.initials: ML
authors.lastname: Ma
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid; D002585:Cesarean Section; D004311:Double-Blind Method; D004338:Drug Combinations; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008614:Meperidine; D010147:Pain Measurement; D010149:Postoperative Pain; D011247:Pregnancy; D013566:Sympathomimetics
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D013566:Sympathomimetics; D008614:Meperidine; D004837:Epinephrine