[Retrospective evaluation of optimal doses of fentanyl by patient-controlled epidural analgesia in management of postoperative pain after gynecological surgery in the elderly].
BACKGROUND
Patient controlled epidural analgesia (PCEA) is a useful method in alleviation of postoperative pain; however, PCEA sometimes provided inadequate pain relief in the elderly. Therefore, we investigated optimal doses of fentanyl by PCEA in management of postoperative pain after gynecological surgery in the elderly.


METHODS
We investigated the pain at rest using 100 mm visual analogue scale (VAS) on the 1st day and 2nd day after the operations. Patients were divided into two groups ; one was well-controlled group (WC group, VAS < 20 mm) and the other was poorly-controlled group (PC group, VAS > or =20 mm). In two groups, we retrospectively compared doses of fentanyl in PCEA, number of demand-PCEA, postoperative nausea as well as vomiting, and delirium during 48 hrs after the operations.


RESULTS
The mean age in WC group was significantly higher than that in PC group. The total dosage of epidural fentanyl did not differ significantly between the groups. In WC group fentanyl of 0.172 microg x kg(-1) hr(-1) was given, and fentanyl 0.197 microg x kg(-1) x hr(-1) in PC group.


CONCLUSIONS
We found that fentanyl 0.172 microg x kg(-1) x 1 hr(-1) by PCEA was the most appropriate dose for alleviation of postoperative pain after gynecological surgery in the elderly.
Kawagoe
Izumi
I
University School of Medicine, Tokyo.
Tajima
Keiko
K
Kanai
Masanori
M
Mitsuhata
Hiromasa
H
D000368:Aged; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies
D000701:Analgesics, Opioid; D005283:Fentanyl