Epidural vs. intravenous infusion of alfentanil in the management of postoperative pain following laparotomies
| Autor: | Rudolf Stienstra, Anton G. L. Burm, J. W. Van Kleef, A. A. Vletter, M. C. O. Van Den Nieuwenhuyzen |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Visual analogue scale Postoperative pain medicine.medical_treatment Analgesic therapy Laparotomy medicine Humans Alfentanil Infusions Intravenous Aged Pain Measurement Chemotherapy Pain Postoperative Morphine business.industry General Medicine Middle Aged Surgery Analgesia Epidural Analgesics Opioid Anesthesiology and Pain Medicine Anesthesia Plasma concentration Female business medicine.drug |
| Zdroj: | Acta anaesthesiologica Scandinavica. 40(9) |
| ISSN: | 0001-5172 |
| Popis: | This study was designed to compare the efficacy of epidural vs. intravenous administration of alfentanil for treatment of postoperative pain.Twenty patients were randomly allocated to one of the two study groups to receive either an epidural bolus dose (0.75 mg) followed by an epidural infusion (0.36 mg/h) (EPI group) or an intravenous infusion (0.36 mg/h) of alfentanil (IV group) for 24 h. These dose regimens were chosen such that equivalent and subanalgesic plasma concentrations of alfentanil were obtained. PCA-morphine was available to both groups. Morphine consumption, pain scores measured on a Visual Analogue Scale (VAS) and the number of demands were used as variables to evaluate the efficacy of the postoperative analgesic therapy. In addition, plasma concentrations of alfentanil were measured.The mean plasma concentrations of alfentanil were similar and20 ng/ml in both groups. Total morphine consumption (EPI: 40 mg, i.v.: 43 mg), pain scores (time when the VAS-score3.0: EPI: median 215 min; i.v.: median 215 min) and number of valid demands (EPI: median 25; i.v.: median 34) did not differ between the groups.Compared to intravenous infusion of alfentanil epidural infusion resulting in the same plasma concentrations is not more effective in relieving postoperative pain. In view of this observation we were not able to demonstrate a spinal mechanism of alfentanil. |
| Databáze: | OpenAIRE |
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