• Ulla-Beth Kroon, Michael Rådström, Carin Hjelthe, Christer Dahlin, and Lars Kroon.
• Department of Obstetrics and Gynaecology, Norra Alvsborg County Hospital, 461 85 Trollhättan, Sweden. ulla-beth.kroon@vgregion.se
• Eur. J. Obstet. Gynecol. Reprod. Biol. 2010 Aug 1;151(2):203-7.

ObjectiveTo investigate if intrathecally administered morphine combined with a low-dose mode of total intravenous anaesthesia (TIVA) accelerates recovery after abdominal surgery as compared, to patient-controlled analgesia (PCA) combined with anaesthesia, based on volatile anaesthetics.Study DesignFifty-three patients who were hysterectomised abdominally were randomised to TIVA or PCA. Their per- and post-operative course was strictly monitored and their pain score was evaluated with a visual analogue scale at repeated time intervals.ResultsPatients with TIVA had a significantly shorter stay on the post-operative ward, 180 (105-330)min, compared with the PCA group, 237 (120-1140)min (p<0.01). The start of peroral fluid also differed significantly between groups, 4h (2-6) for TIVA versus 5h (2-24) for the PCA group (p<0.01). The removal of the indwelling catheter took place significantly earlier in the TIVA group, 9h (5-23) versus 22h (17-24) in the PCA group (p<0.0001). There was significantly less post-operative nausea in the TIVA group compared with the PCA group on the first post-operative day (p<0.01). The length of stay was shorter, 2 days (1-3) compared with 3 days (1-6) for the TIVA group versus PCA (p<0.001). There was no difference in complications between groups. One patient in each group was re-admitted to hospital because of a vaginal cuff infection.ConclusionThe TIVA per- and post-operative care was an advantage over PCA in most respects.Copyright 2010. Published by Elsevier Ireland Ltd.

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