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Article: Patient-controlled alfentanil target-controlled infusion for postoperative analgesia

TitlePatient-controlled alfentanil target-controlled infusion for postoperative analgesia
Authors
Issue Date1996
PublisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0003-2409
Citation
Anaesthesia, 1996, v. 51 n. 5, p. 427-430 How to Cite?
AbstractWe have compared the opioid effects of a patient-demand, target-controlled infusion of alfentanil (n = 10), with patient-controlled bolus administration of morphine (n = 10) following major spinal surgery in Chinese patients aged from 11 to 67 years. The same general anaesthesia regimen was used in all patients. One group of patients were given intra-operative morphine analgesia followed by postoperative intravenous morphine patient-controlled analgesia, while the other group received an intra-operative target-controlled infusion of alfentanil. Following surgery, the alfentanil group were given control of a handset and were able to increase the target alfentanil plasma level in 5 ng.ml-1 increments with a 2-min lockout interval. If analgesia was not demanded within a 15-min period, the computer reduced the target concentration by 5 ng.ml-1. All patients had continuous pulse oximetry monitoring and hourly recording of pain, sedation, nausea scores and respiratory rate. Patients receiving alfentanil had the target concentration noted hourly and four blood samples taken during the first 24 h for measurement of plasma alfentanil concentrations by high performance liquid chromatography. The alfentanil infusion system was equally effective as an analgesic technique when compared with morphine patient-controlled analgesia. There were no hypoxaemic episodes (oxygen saturation <94%), no difference in sedation scores and the incidence of nausea (30%) was the same in both groups. There was a significantly (p < 0.001) lower respiratory rate in the alfentanil group compared with patients receiving morphine at, clinically assessed, equianalgesia. The predicted plasma alfentanil concentrations increased rapidly from about 30 ng.ml-1 during the first 4 h to around 100 ng.ml-1 at the end of the 24-h study period. The precision of the target-controlled infusion system was 75.4% and the mean prediction error (bias) 58.1%, suggesting an underestimation of the measured alfentanil concentrations by the alfentanil infusion system in these Chinese patients. © 1996 The Association of Anaesthetists.
Persistent Identifierhttp://hdl.handle.net/10722/147175
ISSN
2015 Impact Factor: 3.794
2015 SCImago Journal Rankings: 1.404
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorIrwin, MGen_US
dc.date.accessioned2012-05-29T06:00:35Z-
dc.date.available2012-05-29T06:00:35Z-
dc.date.issued1996en_US
dc.identifier.citationAnaesthesia, 1996, v. 51 n. 5, p. 427-430en_US
dc.identifier.issn0003-2409en_US
dc.identifier.urihttp://hdl.handle.net/10722/147175-
dc.description.abstractWe have compared the opioid effects of a patient-demand, target-controlled infusion of alfentanil (n = 10), with patient-controlled bolus administration of morphine (n = 10) following major spinal surgery in Chinese patients aged from 11 to 67 years. The same general anaesthesia regimen was used in all patients. One group of patients were given intra-operative morphine analgesia followed by postoperative intravenous morphine patient-controlled analgesia, while the other group received an intra-operative target-controlled infusion of alfentanil. Following surgery, the alfentanil group were given control of a handset and were able to increase the target alfentanil plasma level in 5 ng.ml-1 increments with a 2-min lockout interval. If analgesia was not demanded within a 15-min period, the computer reduced the target concentration by 5 ng.ml-1. All patients had continuous pulse oximetry monitoring and hourly recording of pain, sedation, nausea scores and respiratory rate. Patients receiving alfentanil had the target concentration noted hourly and four blood samples taken during the first 24 h for measurement of plasma alfentanil concentrations by high performance liquid chromatography. The alfentanil infusion system was equally effective as an analgesic technique when compared with morphine patient-controlled analgesia. There were no hypoxaemic episodes (oxygen saturation <94%), no difference in sedation scores and the incidence of nausea (30%) was the same in both groups. There was a significantly (p < 0.001) lower respiratory rate in the alfentanil group compared with patients receiving morphine at, clinically assessed, equianalgesia. The predicted plasma alfentanil concentrations increased rapidly from about 30 ng.ml-1 during the first 4 h to around 100 ng.ml-1 at the end of the 24-h study period. The precision of the target-controlled infusion system was 75.4% and the mean prediction error (bias) 58.1%, suggesting an underestimation of the measured alfentanil concentrations by the alfentanil infusion system in these Chinese patients. © 1996 The Association of Anaesthetists.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0003-2409en_US
dc.relation.ispartofAnaesthesiaen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAlfentanil - Blood - Therapeutic Useen_US
dc.subject.meshAnalgesia, Patient-Controlled - Methodsen_US
dc.subject.meshAnalgesics, Opioid - Blood - Therapeutic Useen_US
dc.subject.meshConsciousness - Drug Effectsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshInfusions, Intravenousen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMorphine - Therapeutic Useen_US
dc.subject.meshPain, Postoperative - Drug Therapyen_US
dc.subject.meshRespiration - Drug Effectsen_US
dc.subject.meshSpine - Surgeryen_US
dc.titlePatient-controlled alfentanil target-controlled infusion for postoperative analgesiaen_US
dc.typeArticleen_US
dc.identifier.emailIrwin, MG:mgirwin@hku.hken_US
dc.identifier.authorityIrwin, MG=rp00390en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid8694152-
dc.identifier.scopuseid_2-s2.0-0029876733en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0029876733&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume51en_US
dc.identifier.issue5en_US
dc.identifier.spage427en_US
dc.identifier.epage430en_US
dc.identifier.isiWOS:A1996UJ62100004-
dc.publisher.placeUnited Kingdomen_US

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