• Br J Anaesth · Mar 1999

    Randomized Controlled Trial Comparative Study Clinical Trial

    Patient-controlled analgesia: epidural fentanyl and i.v. morphine compared after caesarean section.

    • D W Cooper, U Saleh, M Taylor, S Whyte, D Ryall, M S Kokri, W R Desira, H Day, and E McArthur.
    • South Cleveland Hospital, UK.
    • Br J Anaesth. 1999 Mar 1;82(3):366-70.

    AbstractWe have compared patient-controlled epidural fentanyl (PCEF) and patient-controlled i.v. morphine (PCIM) after Caesarean section in 84 patients, in a randomized, double-blind study. All patients had an epidural and an i.v. patient-controlled analgesia (PCA) device, one of which delivered normal saline. Group PCEF received epidural fentanyl 20 micrograms with a 10-min lockout. Group PCIM received i.v. morphine 1 mg with a 5-min lockout. PCA use was lower for PCEF patients (P = 0.0007). The highest pain score recorded at rest for PCEF patients was median 20 (interquartile range 10-33) mm compared with 32 (14-52) mm for PCIM patients (P = 0.02). The highest pain score recorded on coughing was 31 (21-41) mm with PCEF compared with 56 (30-71) mm for PCIM (P = 0.001). There was less nausea (P = 0.02) and drowsiness (P = 0.0003) with PCEF. There was no difference in the overall incidence and severity of pruritus (P = 0.77). However, pruritus started earlier with PCEF.

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