Patient-controlled analgesia after cesarean delivery: epidural sufentanil versus intravenous morphine

Background and Objectives. The authors studied the efficacy of sufentanil patient-controlled epidural analgesia (PCEA) for postoperative analgesia after cesarean delivery and compared these results to a morphine intravenous-patient-controlled-analgesia (IV-PCA) regimen. Methods. Fifty patients were randomized into two groups to receive sufentanil PCEA or morphine IV-PCA after cesarean delivery under epidural anesthesia. Visual-analog-scale pain scores (0-100 mm: 0 mm = no pain, 100 mm = worst pain), sedation, side effects, recovery times, and patient satisfaction were assessed through 4 p.m. on postoperative day (POD) 2. Results. Analgesia was similar in the two groups, except following the initial physician-administered loading dose when pain was rated significantly lower by patients in the PCEA group at 30 minutes (6 [+ or -] 2 mm versus 38 [+ or -] 6 mm; P < .01) and at 2 hours (7 [+ or -] 2 mm versus 27 [+ or -] 5 mm; P < .05). Sedation was rated lower by patients in the PCEA group at 2 hours (P < .05). The incidence of nausea and vomiting was similar in both groups. The incidence of pruritus requiring treatment was greater in the PCEA group (57% versus 12%; P