Extradural fentanyl for postoperative analgesia: predominant spinal or systemic action?
This randomized, double-blind study of 40 patients was designed to determine if the predominant analgesic effect of extradural fentanyl is mediated by a direct spinal action or an indirect systemic one. After Caesarean section, postoperative analgesia was provided for 24 h by patient-controlled extr...
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Published in | British journal of anaesthesia : BJA Vol. 74; no. 2; pp. 184 - 187 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Oxford
Elsevier Ltd
01.02.1995
Oxford University Press |
Subjects | |
Online Access | Get full text |
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Summary: | This randomized, double-blind study of 40 patients was designed to determine if the predominant analgesic effect of extradural fentanyl is mediated by a direct spinal action or an indirect systemic one. After Caesarean section, postoperative analgesia was provided for 24 h by patient-controlled extradural analgesia (PCEA group) or by patient-controlled i.v. analgesia (PCIVA group). Both groups received a bolus dose of fentanyl 20 μg with a 10-min lockout interval. In the PCIVA group, nine patients stopped early (compared with none in the PCEA group) because of inadequate analgesia. Mean visual analogue pain scores (0–100 mm) at 8 and 12 h were lower for PCEA (23 (SD 13) mm at rest, 31(23) mm on coughing) than for PCIVA (50 (25) mm at rest, 67 (24) mm on coughing) (P < 0.0005). The mean dose of fentanyl self-administered between 4 and 8 h was lower in the PCEA group (38 (So 30) μg h−1 compared with the PCIVA group (59 (27) μg h−1 (P < 0.05). Our results support the hypothesis that the predominant analgesic effect of extradural administration of fentanyl is mediated by a direct spinal action rather than an indirect action from systemic absorption. |
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Bibliography: | ark:/67375/HXZ-M8FG6TJ2-2 ArticleID:74.2.184 istex:AF8671611198104E6BE4FBD9C7FAC2814E7971FC ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23 |
ISSN: | 0007-0912 1471-6771 |
DOI: | 10.1093/bja/74.2.184 |