Epidural Sufentanil for Postoperative Patient-Controlled Analgesia (PCA) With or Without Background Infusion

Abstract

To evaluate the usefulness of a concurrent infusion in patient-controlled epidural analgesia (PCEA), 40 patients scheduled for elective cesarean section under a combined spinal-epidural technique were assigned randomly in a double-blind fashion to receive sufentanil by PCEA with a concomitant infusion of either sufentanil or saline. The sufentanil 24-h consumption was significantly (P < 0.001) higher in those patients receiving the opioid-containing infusion (212.7 +/- 9.5 vs 128.4 +/- 10.8 micrograms, SEM). The number of additional demands and the quality of sleep did not differ between the two groups. The degree of sedation was significantly less pronounced in patients treated with incremental sufentanil doses only. The visual analog scale (VAS) pain scores at rest were identical in both groups except at 6 h (2.5 +/- 0.4 vs 3.7 +/- 0.3, in favor of the patients treated with the sufentanil background infusion). We conclude that, except for a lower pain score during the initial hours, a background infusion in PCEA with sufentanil does not offer major advantages in terms of sleep quality or sufentanil consumption. Side effects may be more pronounced owing to increased drug administration.

Patient‐controlled epidural analgesia versus continuous epidural analgesia after total knee arthroplasty

“…A background infusion in patient‐controlled epidural analgesia with a mixture of fentanyl and bupivacaine has, indeed, been shown to be advantageous in reducing the degree of pain after gastrectomy (19). On the other hand, Vercauteren and co‐workers found that a background infusion in PCEA with sufentanil did not offer any major benefits in terms of quality of analgesia (except during the initial hours) or quality of sleep after elective caesarean section (20). Continuous epidural analgesia with local anaesthetic might be associated with a greater incidence of motor block (21).…”

Patient-controlled epidural analgesia after Caesarean section using meperidine

“…Vercauteren et al 6 compared PCEA with a background infusion versus PCEA alone using sufentanil after Caesarean section and found drug consumption and sedation were greater in patients receiving a background infusion. Analgesia was better in patients receiving an infusion at six hours after surgery but was similar at other times.…”