Comparison of Analgesic Effect and Satisfaction for Intravenous Patient-Controlled Analgesia and Epidural Patient-Controlled Analgesia in Patients Undergoing Cesarean Section with Spinal Anesthesia.
10.4097/kjae.2004.47.3.368
- Author:
Tae In KANG
1
;
Ji Hyang LEE
;
Jong Suk BAN
;
Byung Woo MIN
Author Information
1. Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea. ddabori@hanmail.net
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
PCA;
intravenous;
epidural;
cesarean section;
spinal
- MeSH:
Analgesia, Patient-Controlled*;
Anesthesia, Spinal*;
Bupivacaine;
Butorphanol;
Catheters;
Cesarean Section*;
Female;
Humans;
Incidence;
Ketorolac;
Lower Extremity;
Morphine;
Pain, Postoperative;
Passive Cutaneous Anaphylaxis;
Peritoneum;
Pregnancy;
Pruritus
- From:Korean Journal of Anesthesiology
2004;47(3):368-372
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In many cases, spinal anesthesia is performed in cesarean section. Many women want postoperative pain control. The purpose of this study was to compare the effects of intravenous patient-controlled analgesia (IV-PCA) and epidural patient-controlled analgesia (Epi-PCA) in patients undergoing cesarean section with spinal anesthesia. METHODS: Forty healthy women were randomly assigned to receive IV-PCA or Epi-PCA after cesarean section with spinal anesthesia. The IV-PCA group received ketorolac 30 mg and butorphanol 0.5 mg intravenously when the peritoneum was sutured, followed by IV-PCA with 0.15% ketorolac and 0.005% butorphanol 100 ml (basal infusion rate 2 ml/hr, bolus 2 ml, lock-out time 15 mins). The Epi-PCA group received 0.01% morphine 10 ml via an epidural catheter when the peritoneum was sutured, followed by Epi-PCA with 0.004% morphine and 0.1% bupivacaine 100 ml (basal infusion rate 2 ml/hr, bolus 2 ml, lock-out time 15 mins). The degree of pain was subjectively evaluated using a visual analogue scale (VAS). Patients were evaluated at 2, 6, 12, 24 and 48 hours after operation. Statistical analyses were performed using T-test, Mann White U test and the Chi-square test. RESULTS: VAS was not significantly different at any time, and the incidences of pruritus and sensory and motor changes of the lower extremities were significantly higher in Epi-PCA than IV-PCA. CONCLUSIONS: Although VAS in the two groups was not significantly different, we conclude that IV-PCA is more beneficial than Epi-PCA in patients undergoing cesarean section with spinal anesthesia, because of the side effects of Epi-PCA.
