[Comparison of intravenous fentanyl analgesia and epidural analgesia for postoperative pain relief].
BACKGROUND
Epidural analgesia is available for postoperative pain relief except for the patients with bleeding tendency or under anticoagulation. Intravenous fentanyl analgesia can be applied for such patients but its effect has not been evaluated enough. We compared these two methods after abdominal surgery.


METHODS
In the intravenous fentanyl analgesia group (group iv, n = 15), 0.7 microg x kg(-1) x hr(-1) fentanyl infusion was started during operation and decreased to 0.5 microg x kg(-1) x hr(-1) on the next morning. In the epidural analgesia group (group e, n = 15), 0.4 microg x kg(-1) x hr(-1) fentanyl and 5 ml x hr(-1) 1% mepivacaine infusion was started during operation. The VAS pain score (at rest and at coughing), the level of consciousness, respiratory and cardiovascular depression, nausea and vomiting were evaluated for 3 days.


RESULTS
The VAS scores at rest were similar in two groups but the VAS scores at coughing were similar or lower in the group iv. In the group iv, five patients suffered from nausea and one patient had somnolence. In the group e, only one patient had nausea but two patients had hypotension.


CONCLUSIONS
Intravenous fentanyl analgesia is safe and possibly more effective than epidural analgesia.
Murakami
Tsuyoshi
T
Department of Anesthesiology, Saiseikai Suita Hospital, Suita 564-0013.
Okuda
Yuko
Y
Ishii
Maki
M
Kobayashi
Atsuko
A
Kawamura
Mitsuyoshi
M
D000005:Abdomen / Q000601:surgery; D000368:Aged; D000698:Analgesia / Q000379:methods*; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D019990:Perioperative Care
D000701:Analgesics, Opioid; D008619:Mepivacaine; D005283:Fentanyl