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Patient‐controlled pethidine after major upper abdominal surgery: comparison of the epidural and intravenous routes*†
Author(s) -
Chen P. P.,
Cheam E. W.,
Ma M.,
Lam K. K.,
Ngan Kee W. D.,
Gin T.
Publication year - 2001
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2001.1962-4.x
Subject(s) - pethidine , medicine , anesthesia , bolus (digestion) , abdominal surgery , surgery , patient controlled analgesia , morphine , analgesic
We compared epidural ( n = 17) and intravenous ( n = 20) patient‐controlled analgesia (PCA) using pethidine (bolus 10 mg, lockout interval 10 min, 4‐h maximum dose 3 mg.kg −1 ) after total gastrectomy. We found that mean (SD) pethidine consumption in the first 24 h was 33% less in the epidural group [255 (85) mg] than in the intravenous group [379 (129) mg, p = 0.002], although most of this difference occurred in the first 8 h. Plasma concentrations of pethidine were lower at 8 h (p < 0.01) in the epidural group, but were similar at 24 h. Pain scores, side‐effects, patient satisfaction and patient outcome were similar between groups. Epidural and intravenous pethidine PCA provided similar efficacy after major abdominal surgery, although the epidural route can reduce the amount of pethidine used initially.