• Tsuyoshi Murakami, Yuko Okuda, Maki Ishii, Atsuko Kobayashi, and Mitsuyoshi Kawamura.
• Department of Anesthesiology, Saiseikai Suita Hospital, Suita 564-0013.
• Masui. 2009 Sep 1;58(9):1149-53.

BackgroundEpidural analgesia is available for postoperative pain relief except for the patients with bleeding tendency or under anticoagulation. Intravenous fentanyl analgesia can be applied for such patients but its effect has not been evaluated enough. We compared these two methods after abdominal surgery.MethodsIn the intravenous fentanyl analgesia group (group iv, n = 15), 0.7 microg x kg(-1) x hr(-1) fentanyl infusion was started during operation and decreased to 0.5 microg x kg(-1) x hr(-1) on the next morning. In the epidural analgesia group (group e, n = 15), 0.4 microg x kg(-1) x hr(-1) fentanyl and 5 ml x hr(-1) 1% mepivacaine infusion was started during operation. The VAS pain score (at rest and at coughing), the level of consciousness, respiratory and cardiovascular depression, nausea and vomiting were evaluated for 3 days.ResultsThe VAS scores at rest were similar in two groups but the VAS scores at coughing were similar or lower in the group iv. In the group iv, five patients suffered from nausea and one patient had somnolence. In the group e, only one patient had nausea but two patients had hypotension.ConclusionsIntravenous fentanyl analgesia is safe and possibly more effective than epidural analgesia.

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