Can intravenous patient-controlled analgesia be omitted in patients undergoing laparoscopic surgery for colorectal cancer?.
10.4174/astr.2015.88.2.86
- Author:
Young Yeon CHOI
1
;
Jun Seok PARK
;
Soo Yeun PARK
;
Hye Jin KIM
;
Jinseok YEO
;
Jong Chan KIM
;
Sungsik PARK
;
Gyu Seog CHOI
Author Information
1. Colorectal Cancer Center, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea. kyuschoi@mail.knu.ac.kr
- Publication Type:Comparative Study ; Original Article
- Keywords:
Patient-controlled analgesia;
Laparoscopy;
Colorectal neoplasms
- MeSH:
Analgesia;
Analgesia, Patient-Controlled*;
Colorectal Neoplasms*;
Humans;
Incidence;
Laparoscopy*;
Length of Stay;
Pain, Postoperative;
Passive Cutaneous Anaphylaxis;
Postoperative Nausea and Vomiting;
Retrospective Studies
- From:Annals of Surgical Treatment and Research
2015;88(2):86-91
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Opioid-based intravenous patient-controlled analgesia (IV-PCA) is a popular method of postoperative analgesia, but many patients suffer from PCA-related complications. We hypothesized that PCA was not essential in patients undergoing major abdominal surgery by minimal invasive approach. METHODS: Between February 2013 and August 2013, 297 patients undergoing laparoscopic surgery for colorectal cancer were included in this retrospective comparative study. The PCA group received conventional opioid-based PCA postoperatively, and the non-PCA group received intravenous anti-inflammatory drugs (Tramadol) as necessary. Patients reported their postoperative pain using a subjective visual analogue scale (VAS). The PCA-related adverse effects and frequency of rescue analgesia were evaluated, and the recovery rates were measured. RESULTS: Patients in the PCA group experienced less postoperative pain on days 4 and 5 after surgery than those in the non-PCA group (mean [SD] VAS: day 4, 6.2 [0.3] vs. 7.0 [0.3], P = 0.010; and day 5, 5.1 [0.2] vs. 5.5 [0.2], P = 0.030, respectively). Fewer patients in the non-PCA group required additional parenteral analgesia (41 of 93 patients vs. 53 of 75 patients, respectively), and none in the non-PCA group required rescue PCA postoperatively. The incidence of postoperative nausea and vomiting was significantly higher in the non-PCA group than in the PCA group (P < 0.001). The mean (range) length of hospital stay was shorter in the non-PCA group (7.9 [6-10] days vs. 8.7 [7-16] days, respectively, P = 0.03). CONCLUSION: Our Results suggest that IV-PCA may not be necessary in selected patients those who underwent minimal invasive surgery for colorectal cancer.
