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Patient-controlled Epidural Analgesia with Ropivacaine and Fentanyl: Experience with 2,276 Surgical Patients

Authors
 Shin Hyung Kim ; Kyung Bong Yoon ; Yang Sik Shin ; Chan Mi Kim ; Duck Mi Yoon 
Citation
 Korean Journal of Pain (대한통증연구학회지), Vol.26(1) : 39~45, 2013 
Journal Title
 Korean Journal of Pain (대한통증연구학회지) 
ISSN
 2005-9159 
Issue Date
2013
Abstract
Background: Good postoperative pain control is an important part of adequate postoperative care. Patient-controlled epidural analgesia (PCEA) provided better postoperative analgesia compared to other conventional analgesic methods, but several risks have been observed as well. We therefore surveyed the efficacy and safety of PCEA in this retrospective observational study. Methods: We analyzed collected data on 2,276 elective surgical patients who received PCEA with ropivacaine and fentanyl. Patients were assessed by a PCA service team in the post-anesthesia care unit (PACU), at 1−6 h, 6−24 h, and 24−48 h postoperatively for adequate pain control. The presence of PCEA-related adverse events was also assessed. Results: Numerical pain score (median [interquartile range]) were 3 [1−4], 5 [4−7], 4 [3−5], and 3 [3−5] in the PACU, at 1−6 h, 6−24 h, and 24−48 h postoperatively. Median pain scores in patients underwent major abdominal or thoracic surgery were higher than other surgical procedure in the PACU, at 1−6 h after surgery. Nausea and vomiting (20%) and numbness and motor weakness (15%) were revealed as major PCEA-related adverse events during the postoperative 48 h period. There were 329 patients (14%) for whom PCEA was ceased within 48 h following surgery. Conclusions: Our data suggest that the use of PCEA provides proper analgesia in the postoperative 48 h period after a wide variety of surgical procedures and that is associated with few serious complications. However, more careful pain management and sustainable PCEA monitoring considering the type of surgical procedure undergone is needed in patients with PCEA.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/86166
DOI
10.3344/kjp.2013.26.1.39
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Anesthesiology and Pain Medicine
Yonsei Authors
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