Comparison of patient-controlled epidural analgesia with patient-controlled intravenous analgesia for laparoscopic radical prostatectomy
10.3344/kjp.2018.31.3.191
- Author:
Boo Young HWANG
1
;
Jae Young KWON
;
So Eun JEON
;
Eun Soo KIM
;
Hyae Jin KIM
;
Hyeon Jeong LEE
;
Jihye AN
Author Information
1. Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. jykwon@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Epidural injection;
Intravenous administration;
Laparoscopes;
Morphine;
Oxycodone;
Pain measurement;
Patient-controlled analgesia;
Postoperative pain;
Prostatectomy;
Ropivacaine;
Thoracic vertebrae
- MeSH:
Administration, Intravenous;
Analgesia;
Analgesia, Epidural;
Analgesia, Patient-Controlled;
Analgesics;
Anesthesia, Epidural;
Humans;
Injections, Epidural;
Laparoscopes;
Laparoscopy;
Methods;
Morphine;
Nefopam;
Oxycodone;
Pain Measurement;
Pain, Postoperative;
Passive Cutaneous Anaphylaxis;
Patient Satisfaction;
Pica;
Prostatectomy;
Thoracic Vertebrae
- From:The Korean Journal of Pain
2018;31(3):191-198
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Patient-controlled epidural analgesia (PCEA) is known to provide good postoperative analgesia in many types of surgery including laparoscopic surgery. However, no study has compared PCEA with patient-controlled intravascular analgesia (PCIA) in laparoscopic radical prostatectomy (LARP). In this study, the efficacy and side effects of PCEA and PCIA after LARP were compared. METHODS: Forty patients undergoing LARP were randomly divided into two groups: 1) a PCEA group, treated with 0.2% ropivacaine 3 ml and 0.1 mg morphine in the bolus; and 2) a PCIA group, treated with oxycodone 1 mg and nefopam 1 mg in the bolus. After the operation, a blinded observer assessed estimated blood loss (EBL), added a dose of rocuronium, performed transfusion, and added analgesics. The numeric rating scale (NRS), infused PCA dose, and side effects were assessed at 1, 6, 24, and 48 h. RESULTS: EBL, added rocuronium, and added analgesics in the PCEA group were less than those in the PCIA group. There were no significant differences in side-effects after the operation between the two groups. Patients were more satisfied with PCEA than with PCIA. The NRS and accumulated PCA count were lower in PCEA group. CONCLUSIONS: Combined thoracic epidural anesthesia could induce less blood loss during operations. PCEA showed better postoperative analgesia and greater patient satisfaction than PCIA. Thus, PCEA may be a more useful analgesic method than PICA after LARP.
