[Postoperative on-demand analgesia with XXXX (Fortral)].

@entity1 @entity12586 @entity390 @entity1508 @entity3885 @entity158
@entity1 -controlled analgesia (PCA, intravenous self-application of narcotics) was studied during the early postoperative period. Subjects were 40 ASA I-III @entity1 recovering from elective major and minor surgery (each 20 having undergone abdominal or orthopaedic operations). @entity12586 bolusses of each 8 mg were available via a hand-button whenever the @entity1 felt @entity158 relief necessary, and delivered by a microprocessor-controlled injection pump (On-Demand Analgesia Computer, ODAC). Hourly maximum dose was set to 60 mg with a pump refractory time of 1 min between valid demands. A continuous low-dose @entity12586 infusion (1 mg/h) was additionally administered in order to prevent @entity3885 . Duration of the PCA period was 20.3 +/- 5.9 h (mean, standard deviation). During this time, 20.0 +/- 12.7 demands per @entity1 were recorded resulting in mean @entity12586 consumption of 135.6 +/- 81.4 micrograms/kg/h. Self-administration was characterized by considerable intra- and interindividual variability. There were no statistically significant differences with regard of @entity12586 consumption or @entity158 relief between abdominal and orthopaedic @entity1 , nor could any be demonstrated between the sexes. Similarly, no clear differences were found after various anaesthetic techniques (neuroleptanalgesia, @entity1508 or spinal anaesthesia). Over-all efficacy and @entity1 acceptance proved to be excellent. Effectiveness of PCA was judged superior by about 68% of @entity1 when compared with previously experienced conventional postoperative analgesia. Side effects ( @entity390 , emesis, sweating) occurred in about 10-18% but were usually of minor intensity. Circulatory or respiratory problems were not observed during the PCA period. @entity1 -controlled analgesia is discussed as a promising concept for the treatment of acute @entity158 and clinical @entity158 research.
