title: Remifentanil patient-controlled analgesia effect-site target-controlled infusion compared with morphine patient-controlled analgesia for treatment of acute pain after uterine artery embolization.
abstract: BACKGROUND
  Post-procedural pain control after uterine artery embolization (UAE) of urethral leiomyomata remains a major problem.
  
  
  METHODS
  This double-blind, randomized study tested the possibility to obtain a quicker onset of analgesia by using effect-compartment controlled remifentanil patient-controlled analgesia (remifentanil TCI-PCA) than by using i.v. morphine PCA. Both systems were connected to an i.v. catheter. Active drug or matching placebo administration was activated by a single push-button. Pain was assessed using a numerical rating scale (NRS) from 0 to 10.
  
  
  RESULTS
  NRS values were lower in the remifentanil group (with a possible difference from two to seven points on the scale) during the initial 4 h post-embolization. After the fourth hour, the NRS values were identical between the groups. No major respiratory or haemodynamic side-effect was observed.
  
  
  CONCLUSIONS
  Remifentanil PCA-TCI with a slow and progressive adapted algorithm without any associated premedication or co-medication is feasible in young healthy women undergoing UAE.
authors: Department of Anaesthesia, Institut Jules Bordet, Boulevard de Waterloo 121, 1000 Brussels, Belgium.
authors: M
authors: M
authors: Lipszyc
authors: E
authors: E
authors: Winters
authors: E
authors: E
authors: Engelman
authors: M
authors: M
authors: Baurain
authors: L
authors: L
authors: Barvais
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D018231:Leiomyomatosis / Q000628:therapy; D009020:Morphine / Q000008:administration & dosage; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D000077208:Remifentanil; D014594:Uterine Neoplasms / Q000628:therapy; D014599:Uterus / Q000098:blood supply
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D009020:Morphine; D000077208:Remifentanil