title: The use of patient-controlled epidural fentanyl in elderly patients.
abstract: We studied whether delivering postoperative analgesia, using a patient-controlled epidural analgesia (PCEA) device was effective and safe in elderly patients. We enrolled 40 patients aged > 65 years (elderly group) and 40 patients aged 20-64 years (young group) scheduled for elective major abdominal surgery. PCEA infusion was started following completion of surgery. Mean (SD) fentanyl consumption (10.7 (3.7) compared with 10.5 (2.7) microg.kg(-1), p = 0.76) and number of times patients pressed the bolus switch (32 (36) compared with 44 (38), p = 0.16) during the first 24 h postoperatively were similar in the two groups. Pain scores, which were similar in both groups at rest, were significantly lower in the elderly on coughing (at 24 h, p < 0.05). In addition, average pain scores were similar at the time of PCEA bolus demands in the two groups. Elderly and young adult patients therefore required similar amounts of patient-controlled epidural fentanyl to produce satisfactory pain relief.
authors.affiliation: Yamanashi University Hospital, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan. ishiyama@yamanashi.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Ishiyama
authors.forename: T
authors.initials: T
authors.lastname: Iijima
authors.forename: T
authors.initials: T
authors.lastname: Sugawara
authors.forename: K
authors.initials: K
authors.lastname: Shibuya
authors.forename: H
authors.initials: H
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Terada
authors.forename: M
authors.initials: M
authors.lastname: Ichikawa
authors.forename: D I
authors.initials: DI
authors.lastname: Sessler
authors.forename: T
authors.initials: T
authors.lastname: Matsukawa
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D001835:Body Weight; D003371:Cough / Q000150:complications; D004334:Drug Administration Schedule; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl