Patient-controlled epidural analgesia following caesarean delivery: a comparison of pethidine and fentanyl.

Pethidine and fentanyl have both been used to provide patient-controlled epidural analgesia (PCEA) following caesarean delivery. Both have been compared with epidural morphine but these drugs have not been compared with each other. Patient-controlled epidural analgesia was used in a prospective, randomized, double-blind, cross-over trial to compare fentanyl and pethidine for postoperative epidural analgesia in women having elective caesarean deliveries. Two groups received either PCEA fentanyl or pethidine with a cross-over to the other drug after 24 hours. Results from 45 patients showed no difference in pain level outcomes, but pethidine scored better in all side-effects except for drowsiness at 48 hours. Patients were more satisfied with pethidine (P = 0.015) and overall 65% of patients preferred pethidine. We conclude that pethidine is a suitable drug for patient-controlled epidural analgesia and leads to greater patient satisfaction than does fentanyl.