Is Intravenous Patient Controlled Analgesia Enough for Pain Control in Patients Who Underwent Thoracoscopy?.
10.3346/jkms.2009.24.5.930
- Author:
Jie Ae KIM
1
;
Tae Hyeong KIM
;
Mikyung YANG
;
Mi Sook GWAK
;
Gaab Soo KIM
;
Myung Joo KIM
;
Hyun Sung CHO
;
Woo Seok SIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. anesyang@skku.edu
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Analgesia, Patient-Controlled;
Pain Measurement;
Thoracic Surgery, Video-Assisted
- MeSH:
Adult;
Aged;
Amides/therapeutic use;
Analgesia, Epidural/methods;
Analgesia, Patient-Controlled/*methods;
Analgesics, Opioid/therapeutic use;
Anesthesia, Intravenous/methods;
Anesthetics, Local/therapeutic use;
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use;
Female;
Fentanyl/therapeutic use;
Humans;
Ketorolac/therapeutic use;
Male;
Middle Aged;
Pain Measurement;
Pain, Postoperative/*drug therapy/prevention & control;
Prospective Studies;
Thoracoscopy
- From:Journal of Korean Medical Science
2009;24(5):930-935
- CountryRepublic of Korea
- Language:English
-
Abstract:
This prospective randomized study was conducted to evaluate the efficacy of two common analgesic techniques, thoracic epidural patient-controlled analgesia (Epidural PCA), and intravenous patient-controlled analgesia (IV PCA), in patients undergoing lobectomy by the video-assisted thoracic surgical (VATS) approach. Fifty-two patients scheduled for VATS lobectomy were randomly allocated into two groups: an Epidural PCA group receiving an epidural infusion of ropivacaine 0.2%+fentanyl 5 microg/mL combination at a rate of 4 mL/hr, and an IV PCA group receiving an intravenous infusion of ketorolac 0.2 mg/kg+fentanyl 15 microg/mL combination at a rate of 1 mL/hr. Pain scores were then recorded using the visual analogue scale at rest and during motion (VAS-R and VAS-M, 0-10) for five days following surgery. In addition, we measured the daily morphine consumption, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), satisfaction score, and the incidence of side effects. Thirty-seven patients out of 52 completed the study (18 in the Epidural PCA group, 19 in the IV PCA group). There were no differences in the pain scores, analgesic requirements, pulmonary function, satisfaction score, and the incidence of side effects between groups. This indicates that IV PCA and Epidural PCA are equally effective to control the postoperative pain after VATS lobectomy, which suggests that IV PCA may be used instead of Epidural PCA.
