HYPOXAEMIA AND PAIN RELIEF AFTER LOWER ABDOMINAL SURGERY: COMPARISON OF EXTRADURAL AND PATIENT-CONTROLLED ANALGESIA

We have examined postoperative pain in patients allocated randomly to receive extradural bolus diamorphine 3.6 mg, extradura I infusion of 0.15% bupivacaine with 0.01% diamorphine or patient-controlled i.v. administration of diamorphine at a maximum rate of 1 mg per 5 min, after total abdominal hysterectomy. Extradural infusion analgesia produced the smallest pain scores from 12 to 24 h after surgery (P < 0.05). More patients in the extradural infusion group were moderately hypoxaemic (SpOl < 90% ≯ 12 min h−1) after operation, compared with the two other groups (P < 0.05). The group using patient-controlled analgesia received more diamorphine and suffered a greater incidence of emetic sequelae (P < 0.05).