Korean J Pain.
2007 Dec;20(2):169-173. 10.3344/kjp.2007.20.2.169.
Patient Controlled Analgesia of Alfentanil after a Total Abdominal Hysterectomy: A Comparison of the Intravenous and Epidural Route
- Affiliations
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- 1Department of Anesthesia and Pain Medicine, Eulji Hospital, College of Medicine, Eulji University, Seoul, Korea.
- 2Department of Anesthesia and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea. whlee@cnu.ac.kr
- KMID: 2278060
- DOI: http://doi.org/10.3344/kjp.2007.20.2.169
Abstract
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BACKGROUND: Although the use of intravenous patient controlled analgesia (IVPCA) has been compared to the use of patient conrolled epidural analgesia (PCEA), there is no optimal administration route of alfentanil for the treatment of postoperative pain. This randomized double-blind study compared the efficacy of the use of IVPCA and PCEA for postoperative pain and the side effects after a total abdominal hysterectomy (TAH).
METHODS
Sixty patients undergoing a TAH were randomly assigned to receive either IVPCA (Group I) or PCEA (Group E) for the infusion of alfentanil for postoperative pain control. In both groups, a loading dose of 750 microgram alfentanil was administered. All patients received the same continuous infusion rate (0.3 mg/h), bolus dose (0.15 mg), and lockout time (15 min). The incidence of side effects, the VAS (visual analog scale) of pain, blood pressure, and heart rate were checked for 20 hours after the loading dose injection.
RESULTS
The VAS of pain was not significantly different between the two groups of patients. The onset of the analgesic effect was significantly more rapid in the Group I patients than in the Group E patients. There was no difference in side effects for either group.
CONCLUSIONS
When considering multiple factors such as the onset of analgesia, technical difficulties or infection after the procedure, IVPCA using alfentanil is more useful than PCEA for postoperative pain control after a TAH.
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