A Comparison of Epidural Morphine-Bupivacaine with Intravenous Morphine-Ketorolac in Patient-Controlled Analgesia after Gynecologic Operation.
10.4097/kjae.2004.46.5.560
- Author:
Jeong Hun SUH
1
;
Kum Suk PARK
;
Jung Yeon YUN
;
Sang Hwan DO
Author Information
1. Department of Anesthesiology, College of Medicine, Seoul National University Hospital, Seoul, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
bupivacaine;
ketorolac;
morphine;
patient-controlled analgesia
- MeSH:
Analgesia, Epidural;
Analgesia, Patient-Controlled*;
Analgesics;
Bupivacaine;
Cough;
Female;
Gynecologic Surgical Procedures;
Humans;
Incidence;
Ketorolac;
Morphine;
Nausea;
Pain, Postoperative;
Passive Cutaneous Anaphylaxis;
Pruritus;
Reflex;
Visual Analog Scale;
Vomiting
- From:Korean Journal of Anesthesiology
2004;46(5):560-564
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Postoperative pain control is provided for humanitarian reasons and to alleviate nociception-induced responses, such as endocrine metabolic responses, autonomic reflexes, which have adverse effects on organ function, and other undesirable results. Of the various methods of treatment, patient-controlled analgesia (PCA) is considered the gold standard for the of control postoperative pain. PCA can be administered via intraveous, epidural, or subcutaneous routes. Although patient-controlled epidural analgesia (PCEA) has been compared to IV-PCA, there is no optimal administrative route for the treatment of postoperative pain. This randomized study compared the effectiveness of PCEA and IV-PCA on postoperative pain and the side-effects after gynecologic surgery. METHODS: Ninety-seven patients undergoing gynecologic surgery were randomly assigned to receive either IV-PCA using a mixture of morphine and ketorolac or PCEA using 0.1% bupivacaine and morphine. Pain intensity was tested using a visual analog scale (VAS) until postoperative day 2. Nausea, vomiting, sedation, and pruritus were also measured. RESULTS: Among the 97 patients, 12 patients were excluded during study. Pain relief was better at rest and after coughing in the PCEA group during the 2 postoperative days, except at the first visit. Additional analgesics were used significantly less in the PCEA group, whilst the incidence of other complications was comparable in the IV-PCA and PCEA groups. CONCLUSIONS: After gynecologic surgery, PCEA using bupivacaine and morphine provides better pain relief than IV-PCA using morphine and ketorolac.
