Evaluation of a disposable device for patient-controlled epidural analgesia after caesarean section

We evaluated a disposable device (Baxter PCA Infusor) for patient-controlled epidural analgesia (PCEA) using pethidine in twenty women after lower segment caesarean section. Efficacy, as measured by visual analogue pain scores, was comparable with historical controls from PCEA studies using electronic devices. Three patients reported inadequate analgesia, attributable in two cases to problems with the epidural catheter. PCEA was stopped in one patient because of side-effects. Pethidine consumption ranged from 125 to 1500 mg (median 575 mg) in 48 hours. Plasma concentrations of pethidine varied widely. Disposable devices for PCEA after caesarean section provide an alternative to bolus administration or PCEA using more expensive and cumbersome electronic devices, although we suggest currently available apparatus requires modifications to improve clinical performance.