title: Comparison of patient-controlled analgesia with and without a background infusion after appendicectomy in children.
abstract: BACKGROUND
  There have been many studies using patient-controlled analgesia (PCA) and opioids for postoperative analgesia in children. In this study, we investigated the efficacy, usefulness and analgesic consumption of two different PCA programmes [bolus dose alone (BD) or bolus dose with background infusion (BD + BI)] to evaluate postoperative analgesia for children after emergency appendicectomy.
  
  
  METHODS
  Forty children, aged between 6 and 15 years and ASA class I or II, undergoing emergency appendicectomy were randomly allocated into two groups. The children were given a loading dose of pethidine 0.3 mg.kg-1 and 150 micro g.kg-1 bolus intravenously in group BD (n = 20) and pethidine 0.3 mg.kg-1 loading dose, 75 micro g.kg-1 bolus and 15 micro g.kg-1.h-1 background infusion in group BD + BI (n = 20). The lockout interval was 20 min in both groups.
  
  
  RESULTS
  There were no significant differences in pain, sedation and nausea scores during the 24-h postoperative period between the groups (P > 0.05). Pethidine consumption was significantly lower in group BD + BI than that in group BD for the first 24-h period (P < 0.05).
  
  
  CONCLUSIONS
  We demonstrated that both these PCA programmes were effective and reliable for postoperative pain relief in children. We believe that giving information about PCA to the children and their parents is useful during the preoperative period. However, the background infusion with lower bolus dose in PCA did not increase pethidine consumption.
authors.affiliation: Consultant, Department of Anaesthesiology, Erciyes University Gevher Nesibe Hospital, Kayseri, Turkey. Karamy@erciyes.edu.tr
authors.forename: Karamehmet
authors.initials: K
authors.lastname: Yildiz
authors.forename: Elvan
authors.initials: E
authors.lastname: Tercan
authors.forename: Kudret
authors.initials: K
authors.lastname: Dogru
authors.forename: Ugur
authors.initials: U
authors.lastname: Ozkan
authors.forename: Adem
authors.initials: A
authors.lastname: Boyaci
mesh_terms: D000293:Adolescent; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001062:Appendectomy; D002648:Child; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D008614:Meperidine