Articles: analgesia.
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The use of epidural fentanyl by patient-controlled analgesia (PCA) may be a useful method of providing high-quality postoperative analgesia on the general surgical ward. The successful use of this technique requires an infusion pump with specific characteristics. Three Provider 5500, newly-developed, battery-powered PCA pumps, were tested to determine their accuracy, threshold of occlusion alarm limits and stored volume characteristics. ⋯ This problem did not occur with the addition of an epidural catheter and filter. This device has features which make it suitable for the safe delivery of epidural PCA. Care, however, needs to be taken on changing cartridges to prevent accidental administration of a drug bolus to the patient.
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Seven PCA infusion pumps from seven manufacturers were evaluated. The condition for acceptable use of most of the units is that they not be used at low volumes that could result in overinfusion from the stored volume when an occlusion is cleared. All pumps met most accuracy, electrical safety, and performance criteria. Purchasing decisions should also take into consideration the cost of disposables, application, and medication security.