Extradural sufentanil by patient-controlled analgesia or nurse-administered compared with optimal morphine in a high dependency unit: effects on oxygenation and pain relief after abdominal surgery.

The incidence of apnoeic episodes (> 12 s) was measured in 30 surgical patients allocated randomly to one of three analgesic regimens and all nursed in a high dependency unit. Ten patients received i.m. morphine (mean 52 (range 30-80) mg), administered on request. The remaining 20 patients received extradural sufentanil as an initial bolus dose of 50 micrograms followed by a bolus of 10 micrograms, either self-administered using PCA (10 patients: mean 275 (range 130-450) micrograms) or administered by a nurse on request (10 patients: 144 (70-200) micrograms). With i.m. morphine apnoeic episodes were maximal 2-3 h after administration while after extradural sufentanil, apnoeas were maximal within a few minutes.