title: Patient-controlled pethidine after major upper abdominal surgery: comparison of the epidural and intravenous routes.
abstract: We compared epidural (n = 17) and intravenous (n = 20) patient-controlled analgesia (PCA) using pethidine (bolus 10 mg, lockout interval 10 min, 4-h maximum dose 3 mg.kg(-1)) after total gastrectomy. We found that mean (SD) pethidine consumption in the first 24 h was 33% less in the epidural group [255 (85) mg] than in the intravenous group [379 (129) mg, p = 0.002], although most of this difference occurred in the first 8 h. Plasma concentrations of pethidine were lower at 8 h (p < 0.01) in the epidural group, but were similar at 24 h. Pain scores, side-effects, patient satisfaction and patient outcome were similar between groups. Epidural and intravenous pethidine PCA provided similar efficacy after major abdominal surgery, although the epidural route can reduce the amount of pethidine used initially.
authors.affiliation: Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. ppchen@cuhk.edu.hk
authors.forename: P P
authors.initials: PP
authors.lastname: Chen
authors.forename: E W
authors.initials: EW
authors.lastname: Cheam
authors.forename: M
authors.initials: M
authors.lastname: Ma
authors.forename: K K
authors.initials: KK
authors.lastname: Lam
authors.forename: W D
authors.initials: WD
authors.lastname: Ngan Kee
authors.forename: T
authors.initials: T
authors.lastname: Gin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction
chemical_list: D000701:Analgesics, Opioid; D008614:Meperidine