title: [Postoperative pain management by intravenous patient-controlled analgesia in patients undergoing upper abdominal gastrointestinal surgery].
abstract: BACKGROUND
  We conducted a retrospective study to evaluate the effectiveness of intravenous patient-controlled analgesia (IVPCA) in the early postoperative period after upper abdominal gastrointestinal surgery. We also evaluated the postoperative effects of intraoperative analgesic dosage in patients after this surgery.
  
  
  METHODS
  A total of 59 adult patients classified as ASA 1-3 were allocated to one of two groups: Group A, 23 patients who requested IVPCA more than 50 times, and Group B, 36 patients with fewer than 50 requests. IVPCA was induced using morphine 1 mg x ml(-1) without a base dose. The bolus dose was 1 ml and the lock-out time was 5 min.
  
  
  RESULTS
  There was no significant difference between the two groups in the total intraoperative remifentanil dosage/body weight/surgical duration, predicted effect-site concentration of fentanyl during extubation, and utilization of flurbiprofen. The doses of morphine were significantly higher, and the visual analogue scale scores for pain at rest and during movement tended to be lower in group A than in group B.
  
  
  CONCLUSIONS
  The results of this study suggest that the effects of intraoperative analgesics may not be significant. Patients who had received the above mentioned anesthetic regimen intraoperatively also required full postoperative analgesia as well.
authors.affiliation: Department of Anesthesiology and Clinical Care, Hiroshima University Hospital, Hiroshima 734-8551.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kajiyama
authors.forename: Tomoko
authors.initials: T
authors.lastname: Niihata
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sugimoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawamoto
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000706:statistics & numerical data; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine