Pre‐emptive analgesia form intravenous administration of opioids

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Abstract
Summary: Forty patients undergoing total abdominal hysterectomy were randomly allocated to reveive either 40 μ. Kg−1 of alfentanil on induction of anaesthesia or 40 μ.kg−1 of alfentanil after the skin incision, Postoperative pain relief was provided with morphine from a patient‐controlled analgesia system. The amount of morphine consumed in the poperating theatre, while in recovery and for the first 24 h postoperatively was recorded. Pain scores were assed at 24 h using a visual analogue scale. There were no differences found between the two group for morophine consumption but the ‘pre‐emptive’ group had significantly higher pain scores at rest. We conclude that there is no clinically useful pre‐emptive analgesic effect with this dose of alfentanil and that therefore systemic opioid premedication in unlikely to decrease postoperative analgesic requirements throught the mechanism of pre‐emptive analgesia.