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http://dx.doi.org/10.3344/kjp.2018.31.3.191

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)
Publication Information
The Korean Journal of Pain / v.31, no.3, 2018 , pp. 191-198 More about this Journal
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
Epidural injection; Intravenous administration; Laparoscopes; Morphine; Oxycodone; Pain measurement; Patient-controlled analgesia; Postoperative pain; Prostatectomy; Ropivacaine; Thoracic vertebrae;
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