Randomised double-blind comparison of morphine vs. a morphine-alfentanil combination for patient-controlled analgesia.
In a randomised, double-blind study, we compared a combination of morphine and alfentanil with morphine alone for patient-controlled analgesia (PCA) after Caesarean section under spinal anaesthesia. After surgery, patients were randomly allocated to receive PCA with a bolus dose of either morphine 0.75 mg plus alfentanil 0.125 mg (Group MA, n = 40) or morphine 1.5 mg alone (Group M, n = 37) with a lockout interval of 8 min and no hourly dose limit. Clinical assessments were made in the first 24 h, after which patients completed a written questionnaire. There were no differences between groups in PCA usage or visual analogue scale pain scores measured at 2, 4, 6 and 24 h. There was a low incidence of side-effects in both groups. In the questionnaire, patients in Group MA scored higher compared with Group M when asked to grade speed of onset and effectiveness of analgesia after a PCA bolus; there were no differences in grading for duration of analgesia or overall patient satisfaction. Addition of alfentanil to morphine may have advantages for PCA.
Ngan Kee
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WD
Associate Professor, Department of Anaesthesia, The Chinese University of Hong Kong, China.
Khaw
K S
KS
Wong
E L
EL
D000328:Adult; D015760:Alfentanil / Q000008:administration & dosage*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004311:Double-Blind Method; D004338:Drug Combinations; D006801:Humans; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*
D000701:Analgesics, Opioid; D004338:Drug Combinations; D015760:Alfentanil; D009020:Morphine