Optimal dosing interval for epidural pethidine after Caesarean section
| Autor: | Willem Lombard, Karen Pedersen, Michael R Lorimer |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
music.instrument Nausea business.industry medicine.medical_treatment Analgesic Surgery Pethidine Anesthesiology and Pain Medicine Patient satisfaction Interquartile range Anesthesia Threshold of pain Emergency Medicine medicine Lower segment caesarean section Caesarean section medicine.symptom music business medicine.drug |
| Zdroj: | Acute Pain. 4:27-31 |
| ISSN: | 1366-0071 |
| DOI: | 10.1016/s1366-0071(02)00007-4 |
| Popis: | Background: The optimal dosing interval for epidural pethidine after lower segment Caesarean section (LSCS) is unknown. We challenged our current three hourly minimum dosing interval with an hourly dosing interval. Methods: After random assignment, intermittent epidural pethidine (50 mg on demand) was prescribed with a lockout interval of 1 h (group A) or 3 h (group B) for the first day after LSCS. Visual analogue pain scores (VAS 0–100) at rest and on movement were recorded at the time of request and again 30 min after. Side effects and patient satisfaction scores were monitored. Results: Thirty-seven women were enrolled: 18 in group A, 19 in group B. The median (interquartile range) dosing interval was similar in both groups: group A 220 min (178–246 min); group B 233 min (188–241 min). Request for further analgesia occurred at comparable VAS of 26 and 25 at rest and 44 and 43 on movement in groups A and B respectively. Mean pain scores 30 min later were also similar: 5 versus 3 at rest and 13 versus 13 on movement. The pain threshold variability at which analgesia was requested was higher for pain at rest (coefficient of variability, CV, 50%) than for pain with movement (CV 35%). The incidence of troublesome side effects was nausea 16%, pruritus 2.8% and drowsiness 14%. A higher frequency of mild symptoms were reported for pruritus (50%) and drowsiness (57%). Patient satisfaction was high (88%, S.D. 21). Conclusions: Epidural pethidine 50 mg is an effective analgesic after LSCS. A lockout period of 3 h would deny 28% of patient requests. We projected that this denial rate could be reduced to 7% by shortening the lockout period to 2 h. Patient satisfaction scores were high despite frequently reported mild symptoms. Pain on movement is a more reliable indicator of analgesic need than pain at rest. |
| Databáze: | OpenAIRE |
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