ISSN:
1365-2044
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
The aims of this study were to determine the effect of three different modes of epidural administration of fentanyl on oxyhaemoglobin saturation and pain control. Forty-three patients undergoing elective abdominal surgery were randomly allocated to the following groups: (1) continuous infusion of fentanyl at a rate of 50 μg.h−1 with additional epidural boluses (25 μg.Ug) as required; (2) patient-controlled analgesia using a 25 fig epidural bolus of fentanyl with a 15 min lockout period; (3) a combination of patient-controlled analgesia and continuous infusion. Oxyhaemoglobin saturation was measured by continuous computerised pulse oximetry for 48 h after operation together with pain and sedation scores. In the first 24 h after surgery patients in the continuous infusion group spent a significantly greater proportion of time below oxygen saturations of 94% and 85% than those in the other two groups. On day 2 all oxygen saturation measurements were worse than during day 1, but differences between groups were not significant. Those patients receding patient-controlled analgesia required significantly less fentanyl than patients in either of the other groups (p 〈 0.05). However, the mean pain and sedation scores did not differ significantly between the three treatment groups. There was no association between total fentanyl dose and oxygen saturation values. Overall, self-administered fentanyl appeared to cause less oxyhaemoglobin desaturation than nurse-administered analgesia without any loss of analgesic effect.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1365-2044.1993.tb06784.x
