Introduction:Alfentanil has a shorter onset and duration of action compared to morphine.A study conducted in our PACU in Feb06 showed the median interval before analgesia with intravenous morphine was 30min.This prompted us to prospectively study a combination of 1mg alfentanil and 10mg morphine(ALFINE)for postop analgesia.

Materials and Methods: 50 postop patients with moderate to severe pain were audited.The patients were adults undergoing general,gynaecological,orthopaedic and ENToperations.Verbal rating pain scores and vital signs were recorded at start,“pain OK and at discharge.Patients were interviewed on the first postop day for initial pain,speed of onset of pain relief and overall satisfaction on a verbal rating scale of 1-10.Data collection was done using a proforma and analysed using simple statistical methods.

Results:ALFINE was approximately twice as potent as morphine.The median time for “pain OK” was 23min,significantly different to morphine(P<0.01).Patients reported better pain relief. Conclusions:Our study showed a significant difference in time of onset of analgesia with ALFINE compared to morphine, it was rated favourably by patients and nurses.Even though ALFINE was equally efficacious and more potent, it was not a cost effective alternative.We suggest that the better patient satisfaction and onset of analgesia scores of ALFINE would favour its use as a PCA.