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The efficacy of elastomeric patient-control module when connected to a balloon pump for postoperative epidural analgesia: A randomized, noninferiority trial

Authors
 Myung Hwa Kim  ;  Yon Hee Shim  ;  Min-Soo Kim  ;  Yang-Sik Shin  ;  Hyun Joo Lee  ;  Jeong Soo Lee 
Citation
 Medicine, Vol.96(2) : 5828, 2017 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Amides/administration & dosage ; Analgesia, Epidural/methods* ; Analgesia, Patient-Controlled/methods* ; Analgesics, Opioid/administration & dosage ; Anesthetics, Local/administration & dosage ; Female ; Fentanyl/administration & dosage ; Humans ; Male ; Middle Aged ; Pain, Postoperative/drug therapy* ; Young Adult
Keywords
epidural analgesia ; patient-controlled analgesia ; postoperative pain
Abstract
When considering the principles of a pain control strategy by patients, reliable administration of additional bolus doses is important for providing the adequate analgesia and improving patient satisfaction. We compared the efficacy of elastomeric patient-control module (PCM) with conventional PCM providing epidural analgesia postoperatively.A noninferiority comparison was used. Eighty-six patients scheduled for open upper abdominal surgery were randomized to use either an elastomeric or conventional PCM connected to balloon pump. After successful epidural catheter insertion at T6-8 level, fentanyl (15-20 μg/kg) in 0.3% ropivacaine 100 mL was administered at basal rate 2 mL/h with bolus 2 mL and lock-out time 15 minutes. The primary outcome was the verbal numerical rating score for pain.The 95% confidence intervals for differences in pain scores during the first 48 hours postoperatively were <1, indicating noninferiority of the elastomeric PCM. The duration of pump reservoir exhaustion was shorter for the elastomeric PCM (mean [SD], 33 hours [8 hours] vs 40 hours [8 hours], P = 0.0003). There were no differences in the frequency of PCM use, additional analgesics, or adverse events between groups.The elastomeric PCM was as effective as conventional PCM with and exhibited a similar safety profile.
Files in This Item:
T201700133.pdf Download
DOI
10.1097/MD.0000000000005828
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Hwa(김명화) ORCID logo https://orcid.org/0000-0003-4723-9425
Kim, Min Soo(김민수) ORCID logo https://orcid.org/0000-0001-8760-4568
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
Lee, Jeong Soo(이정수) ORCID logo https://orcid.org/0000-0002-8947-3706
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154125
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