Background Infusion (background + infusion)

Distribution by Scientific Domains


Selected Abstracts


Patient-controlled epidural technique improves analgesia for labor but increases cesarean delivery rate compared with the intermittent bolus technique

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2004
P. Halonen
Background:, We tested the hypothesis that patient-controlled epidural analgesia for labor (PCEA) provides better analgesia and satisfaction than the intermittent bolus technique (bolus) without affecting the mode of delivery. Methods:, We randomized 187 parturients to receive labor analgesia using either the PCEA or bolus technique. The PCEA group received a starting bolus of 14 mg of bupivacaine and 60 µg of fentanyl in a 15-ml volume, followed by a background infusion (bupivacaine 0.08% and fentanyl 2 µg ml,1) 5 ml h,1 with a 5-ml bolus and 15-min lock-out interval. The bolus group received boluses of 20 mg of bupivacaine and 75 µg of fentanyl in a 15-ml volume. Results:, Parturients in the PCEA group had significantly (P < 0.05,0.01) less pain during the first and second stages of labor. There was no difference in the spontaneous delivery rate between the groups, but the cesarean delivery rate was significantly (P < 0.05) higher (16.3% vs. 6.7%) in the PCEA group than in the bolus group. Bupivacaine consumption was significantly (P < 0.01) higher (11.2 mg h,1 vs. 9.6 mg h,1) and the second stage of labor was significantly (P < 0.01) longer (70 min vs. 54 min) in the PCEA group than in the bolus group. Patient satisfaction was equally good in both groups. Conclusion:, The PCEA technique provided better pain relief. This was associated with higher bupivacaine consumption, prolongation of the second stage of labor, and an increased rate of cesarean section. [source]


Comparison of patient-controlled analgesia with and without a background infusion after appendicectomy in children

PEDIATRIC ANESTHESIA, Issue 5 2003
Karamehmet Yildiz MD
Summary Background: There have been many studies using patient-controlled analgesia (PCA) and opioids for postoperative analgesia in children. In this study, we investigated the efficacy, usefulness and analgesic consumption of two different PCA programmes [bolus dose alone (BD) or bolus dose with background infusion (BD + BI)] to evaluate postoperative analgesia for children after emergency appendicectomy. Methods: Forty children, aged between 6 and 15 years and ASA class I or II, undergoing emergency appendicectomy were randomly allocated into two groups. The children were given a loading dose of pethidine 0.3 mg·kg,1 and 150 ,g·kg,1 bolus intravenously in group BD (n = 20) and pethidine 0.3 mg·kg,1 loading dose, 75 ,g·kg,1 bolus and 15 ,g·kg,1·h,1 background infusion in group BD + BI (n = 20). The lockout interval was 20 min in both groups. Results: There were no significant differences in pain, sedation and nausea scores during the 24-h postoperative period between the groups (P > 0.05). Pethidine consumption was significantly lower in group BD + BI than that in group BD for the first 24-h period (P < 0.05). Conclusions: We demonstrated that both these PCA programmes were effective and reliable for postoperative pain relief in children. We believe that giving information about PCA to the children and their parents is useful during the preoperative period. However, the background infusion with lower bolus dose in PCA did not increase pethidine consumption. [source]


Regional anaesthesia elastomeric pump performance after a single use and subsequent refill: a laboratory study

ANAESTHESIA, Issue 7 2009
C. R. K. Grant
Summary Ambulatory local anaesthetic delivery systems are often limited by a short effective duration of infusion. Prolonging nerve blockade by substituting a new pump as recommended by the manufacturers, represents a substantial consumable item cost ($US300,500). We therefore evaluated the flow delivery performance of 31 single model elastomeric devices (all with a 2 ml.h,1 background and 5 ml every hour bolus capability) that had been filled, used in clinical practice and then refilled in the laboratory. For the second infusion, there was a pattern of over-infusion (< 10 ml.h,1) in the first hour; however, all pumps depreciated to < 150% of predicted by the second hour. The subsequent performance of all pumps was not only within safe limits, but also predominantly within the range (background infusion ± 15%, bolus +10/,20%) specified by the manufacturer for primary infusion. We conclude that this elastomeric regional anaesthesia pump design performs satisfactorily after having been refilled following a single previous use. [source]