Abstract
Purpose
To determine the effects of the addition of a background infusion to patient-controlled epidural analgesia (PCEA) using mependine for analgesia after Caesarean section.
Methods
In a randomized, double-blind study. we assigned 40 patients having elective Caesarean section to receive postoperative analgesia by patient-controlled epidural analgesia (PCEA) using mependme 5 mg · ml−1 with (group Pi) or without (group Po) a background infusion of 10 mg · hr−1. The PCEA settings (20 mg bolus. 10 mm lockout interval, four-hour maximum dose 150 mg) were otherwise identical. We compared pain at rest, pain on coughing, side effects, number of PCEA demands, drug consumption and patient satisfaction between groups in the first 24 hr after surgery.
Results
Total consumption of mependme was greater in group Pi (median 390 mg) than in group Po (median 240 mg; P = 0.017) and the number of PCEA demands was greater in group Po (median 12) than in group Pi (median 7.5;P = 0.012). Analgesia, side effects and patient satisfaction was similar between groups.
Conclusion
Addition of a background infusion to PCEA using mependine after Caesarean section has no clinical benefit.
Résumé
Objectif
Déterminer après la césarienne les effets de la perfusion continue pour l’analgésie épidurale autocontrôlée (PCEA) à la mépéridine.
Méthodes
Au cours d’une étude aléatoire, en double aveugle, nous avons désigné 40 partunentes programmées pour une césarienne non urgente pour une analgésie épidurale auto-contrôlée avec mépéridine 5 mg · ml avec (groupe Pi) ou sans (groupe Po) une perfusion continue de 10 mg · h−1. Le réglage de la PCEA (dose de charge 20 mg, intervalle réfractaire 10 min, dose maximale 150 mg aux quatre heures) étaient les mêmes. Nous avons comparé entre les groupes, la douleur au repos, à la toux, les effets secondaires, le nombre de demandes de PCEA. l’utilisation du morphinique et la satisfaction de la patiente pendant les premières 23 h.
Résultats
L’utilisation totale de mépéridine était plus importante dans le groupe Pi (médiane 390 mg) que dans le groupe Po (médiane 240 mg;P = 0.017) et le nombre de demandes de PCEA était plus important dans le groupe Po (médiane 12) que dans le groupe Pi (médiane 7.5;P = 0.01 2). L’analgésie, les effets secondaires et la satisfaction de la patiente étaient identiques entre les groupes.
Conclusion
Après la césarienne, l’ajout d’une perfusion continue à la PCEA à la mépéridine ne procure pas d’avantages cliniques.
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Kee, W.D.N., Khaw, K.S. & Ma, M.L. Patient-controlled epidural analgesia after Caesarean section using meperidine. Can J Anaesth 44, 702–706 (1997). https://doi.org/10.1007/BF03013381
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DOI: https://doi.org/10.1007/BF03013381