PATIENT-MAINTAINED ANALGESIA WITH TARGET-CONTROLLED ALFENTANIL INFUSION AFTER CARDIAC-SURGERY - A COMPARISON WITH MORPHINE PCA

The performance of a patient-demand, target-controlled alfentanil infu sion system was compared with that of a traditional morphine patient-c ontrolled analgesia (PCA) pump in 120 adult patients after cardiac sur gery. Patients were randomized to one of the two PCA systems for their postoperative analgesia in the intensive care unit and pain, nausea a nd sedation scores were recorded every 4 h for the first 24 h. Episode s of hypoxaemia, myocardial ischaemia and haemodynamic instability wer e also recorded. In patients using the alfentanil system the overall m edian visual analogue pain score was 2.3 (95% CI 2.3-2.8) compared wit h 3.0 (95% CI 2.7-3.2) in those using morphine PCA (P < 0.05), but bot h systems delivered high-quality analgesia. The two groups did not dif fer with respect to the overall sedation scores, the frequency of post operative nausea and vomiting, haemodynamic instability, myocardial is chaemia or hypoxaemia.