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Epidural patient-controlled analgesia: influence of bupivacaine and hydromorphone basal infusion on pain control after cesarean delivery.
Anesth Analg. 1992 Nov; 75(5):740-6.A&A

Abstract

Epidural administration of hydromorphone was evaluated using a patient-controlled analgesia (PCA) delivery system in 170 healthy women undergoing elective cesarean delivery with epidural bupivacaine who were randomly assigned to one of four epidural PCA treatment groups: group I, hydromorphone alone by bolus administration; group II, hydromorphone, with a continuous (basal) infusion; group III, hydromorphone in combination with 0.08% bupivacaine by bolus administration; or group IV, hydromorphone and bupivacaine, with a concurrent infusion of both drugs. Patients in group I required significantly less opioid medication (2.1 +/- 1.1 mg [mean +/- SD]) during the first 24 h than patients in group II (3.3 +/- 1.3 mg). Similarly, patients in group III self-administered significantly less hydromorphone (2.0 +/- 1.0 mg) and bupivacaine (23.3 +/- 11.4 mg) during the first 24 h of PCA therapy, compared with patients in group IV (hydromorphone [2.7 +/- 1.1 mg] and bupivacaine [31.5 +/- 11.6 mg]). The concomitant use of a local anesthetic or basal opioid infusion with hydromorphone via epidural PCA did not decrease the number of PCA demands or delivered doses. In addition, patients in all four groups had similar pain, sedation, discomfort, fatigue, and anxiety scores. The frequency of awakening at night to self-administer analgesic medication was not decreased when a basal infusion was used.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Parker RK
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
Sawaki Y
No affiliation info available
White PF
No affiliation info available

MeSH

AdultAnalgesia, EpiduralAnalgesia, Patient-ControlledBupivacaineCesarean SectionDouble-Blind MethodFemaleHumansHydromorphonePain, PostoperativePregnancyProspective Studies

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1384397

Clinical Trial Links

Spinal Hydromorphone Versus Morphine for Post-Cesarean Delivery Analgesia

Citation

Parker, R K., et al. "Epidural Patient-controlled Analgesia: Influence of Bupivacaine and Hydromorphone Basal Infusion On Pain Control After Cesarean Delivery." Anesthesia and Analgesia, vol. 75, no. 5, 1992, pp. 740-6.
Parker RK, Sawaki Y, White PF. Epidural patient-controlled analgesia: influence of bupivacaine and hydromorphone basal infusion on pain control after cesarean delivery. Anesth Analg. 1992;75(5):740-6.
Parker, R. K., Sawaki, Y., & White, P. F. (1992). Epidural patient-controlled analgesia: influence of bupivacaine and hydromorphone basal infusion on pain control after cesarean delivery. Anesthesia and Analgesia, 75(5), 740-6.
Parker RK, Sawaki Y, White PF. Epidural Patient-controlled Analgesia: Influence of Bupivacaine and Hydromorphone Basal Infusion On Pain Control After Cesarean Delivery. Anesth Analg. 1992;75(5):740-6. PubMed PMID: 1384397.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidural patient-controlled analgesia: influence of bupivacaine and hydromorphone basal infusion on pain control after cesarean delivery. AU - Parker,R K, AU - Sawaki,Y, AU - White,P F, PY - 1992/11/1/pubmed PY - 1992/11/1/medline PY - 1992/11/1/entrez SP - 740 EP - 6 JF - Anesthesia and analgesia JO - Anesth Analg VL - 75 IS - 5 N2 - Epidural administration of hydromorphone was evaluated using a patient-controlled analgesia (PCA) delivery system in 170 healthy women undergoing elective cesarean delivery with epidural bupivacaine who were randomly assigned to one of four epidural PCA treatment groups: group I, hydromorphone alone by bolus administration; group II, hydromorphone, with a continuous (basal) infusion; group III, hydromorphone in combination with 0.08% bupivacaine by bolus administration; or group IV, hydromorphone and bupivacaine, with a concurrent infusion of both drugs. Patients in group I required significantly less opioid medication (2.1 +/- 1.1 mg [mean +/- SD]) during the first 24 h than patients in group II (3.3 +/- 1.3 mg). Similarly, patients in group III self-administered significantly less hydromorphone (2.0 +/- 1.0 mg) and bupivacaine (23.3 +/- 11.4 mg) during the first 24 h of PCA therapy, compared with patients in group IV (hydromorphone [2.7 +/- 1.1 mg] and bupivacaine [31.5 +/- 11.6 mg]). The concomitant use of a local anesthetic or basal opioid infusion with hydromorphone via epidural PCA did not decrease the number of PCA demands or delivered doses. In addition, patients in all four groups had similar pain, sedation, discomfort, fatigue, and anxiety scores. The frequency of awakening at night to self-administer analgesic medication was not decreased when a basal infusion was used.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/1384397/Epidural_patient_controlled_analgesia:_influence_of_bupivacaine_and_hydromorphone_basal_infusion_on_pain_control_after_cesarean_delivery_ DB - PRIME DP - Unbound Medicine ER -