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British Journal of Anaesthesia, 1993, Vol. 71, No. 6 818-822
© 1993 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

PATIENT-CONTROLLED ANALGESIA WITH LOW DOSE BACKGROUND INFUSIONS AFTER LOWER ABDOMINAL SURGERY IN CHILDREN

E. DOYLE, F.R.C.A., I. HARPER, B.M., B.CH. and N. S. MORTON, F.R.C.A.

Department of Anaesthesia, Royal Hospital for Sick Children Yorkhill, Glasgow G3 8SJ

Correspondence to E.D.

Forty-five children (aged 6–12 yr) undergoing appendicectomy received one of three analgesic regimens using patient-controlled analgesia (PCA) with morphine: no background infusion (BO); background infusion 4 µg kg–1 h–1 (B4); background infusion 10 µh–1 h–1 (B10). Total consumption of morphine was greater in group B10 compared with groups BO (P<0.01) and B4 (P<0.05). There was no significant difference in morphine consumption in groups BO and B4. All three groups self-administered similar amounts of morphine and there were no significant differences in pain scores or incidence of excessive sedation. Group B4 suffered less hypoxaemia compared with groups BO (P<0.01) and B10 (P<0.001). Group B10 suffered more nausea and vomiting than groups BO (P<0.001) and B4 (P<0.001), but there was no significant difference in the incidence of nausea and vomiting between groups BO and B4. Groups B4 and B10 spent more time at night asleep than group BO (P<0.05). There were no significant differences between the groups in the amount of time spent asleep during the day. Inclusion of a background infusion of morphine 4 µg kg–1 h–1 in a PCA regimen for children did not increase the incidence of side effects and was associated with less hypoxaemia and a better sleep pattern than no background infusion. (Br. J. Anaesth. 1993; 71: 818–822)


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