COMPARISON OF PATIENT-CONTROLLED EPIDURAL ANALGESIA WITH PATIENT-CONTROLLED INTRAVENOUS ANALGESIA USING PETHIDINE OR FENTANYL

We compared patient-controlled epidural analgesia (PCEA) with patient- controlled intravenous analgesia (PCIA) using pethidine or fentanyl in a randomized double-blind crossover study of 80 patients after caesar ean section. Patients received pethidine by PCEA or PCIA, or fentanyl by PCEA or PCIA, with a crossover of the route of administration at 12 h. For pethidine, pain scores were lower with PCEA vs PCIA from 4 to 1 6h (P<0.05). Pethidine consumption was lower with PCEA vs PCIA from 12 to 24h (P=0.0005). Patients preferred PCEA to PCIA (P=0.015). For fen tanyl, pain scores were lower with PCEA vs PCIA at 12h (P=0.045). Fent anyl consumption was lower with PCEA. vs PCIA from 0 to 12h (P=0.0007) . Patients had similar preference far PCEA and PCIA. Pain scores and s ide-effects were similar between drugs. Plasma pethidine was similar b etween groups. Plasma fentanyl was higher with PCIA Ils PCEA at 12h (P =0.002). PCEA has advantages over PCIA and pethidine may be the prefer red drug.