The use of patient-controlled epidural fentanyl in elderly patients.
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.
Ishiyama
T
T
Yamanashi University Hospital, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan. ishiyama@yamanashi.ac.jp
Iijima
T
T
Sugawara
T
T
Shibuya
K
K
Sato
H
H
Terada
Y
Y
Ichikawa
M
M
Sessler
D I
DI
Matsukawa
T
T
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
D000701:Analgesics, Opioid; D005283:Fentanyl