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

 Shin Hyung Kim  ;  Kyung Bong Yoon  ;  Duck Mi Yoon  ;  Chan Mi Kim  ;  Yang Sik Shin 
 KOREAN JOURNAL OF PAIN, Vol.26(1) : 39-45, 2013 
Journal Title
Issue Date
efficacy ; epidural analgesia ; patient-controlled analgesia ; postoperative pain ; safety
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.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Shin Hyung(김신형) ORCID logo https://orcid.org/0000-0003-4058-7697
Shin, Yang Sik(신양식)
Yoon, Kyoung Bong(윤경봉) ORCID logo https://orcid.org/0000-0002-4167-1375
Yoon, Duck Mi(윤덕미)
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