The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Comparison of patient-controlled epidural analgesia with patient-controlled intravenous analgesia for laparoscopic radical prostatectomy

  • Hwang, Boo Young (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Kwon, Jae Young (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Jeon, So Eun (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Eun Soo (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Hyae Jin (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Lee, Hyeon Jeong (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • An, Jihye (Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital)
  • Received : 2018.03.13
  • Accepted : 2018.06.20
  • Published : 2018.07.01
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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.

Keywords

References

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