EVALUATION OF A DISPOSABLE DEVICE FOR PATIENT-CONTROLLED EPIDURAL ANALGESIA AFTER CESAREAN-SECTION

We evaluated a disposable device (Baxter PCA Infusor) for patient-cont rolled epidural analgesia (PCEA) using pethidine in twenty women after lower segment caesarean section. Efficacy, as measured by visual anal ogue pain scores, was comparable with historical controls from PCEA st udies using electronic devices. Three patients reported inadequate ana lgesia, attributable in two cases to problems with the epidural cathet er. PCEA was stopped in one patient because of side-effects. Pethidine consumption ranged from 125 to 1500 mg (median 575 mg) in 48 hours. P lasma concentrations of pethidine varied widely. Disposable devices fo r PCEA after caesarean section provide an alternative to bolus adminis tration or PCEA using more expensive and cumbersome electronic devices , although we suggest currently available apparatus requires modificat ions to improve clinical performance.