Browse > Article
http://dx.doi.org/10.3340/jkns.2011.50.3.205

A Comparison of the Effect of Epidural Patient-Controlled Analgesia with Intravenous Patient-Controlled Analgesia on Pain Control after Posterior Lumbar Instrumented Fusion  

Lee, Sang-Hoon (Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine)
Kim, Kyung-Hyun (Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine)
Cheong, Seong-Mee (Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine)
Kim, Su-Mi (Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine)
Kooh, Mi-Rang (Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine)
Chin, Dong-Kyu (Department of Neurosurgery, The Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.50, no.3, 2011 , pp. 205-208 More about this Journal
Abstract
Objective : Retrospective analysis to compare the effect and complication of epidural patient-controlled analgesia (epidural PCA) with intravenous patient-controlled analgesia (IV PCA) for the treatment of the post-operative pain after posterior lumbar instrumented fusion. Methods : Sixty patients who underwent posterior lumbar instrumented fusion for degenerative lumbar disease at our institution from September 2007 to January 2008 were enrolled in this study. Out of sixty patients, thirty patients received IV PCA group and thirty patients received epidural PCA group. The pain scale was measured by the visual analogue scale (VAS) score. Results : There were no significant difference between IV PCA group and epidural PCA group on the PCA related complications (p=0.7168). Ten patients in IV PCA group and six patients in epidural PCA group showed PCA related complications. Also, there were no significant differences in reduction of VAS score between two groups on postoperative 2 hours (p=0.9618) and 6 hours (p=0.0744). However, postoperative 12 hours, 24 hours and 48 hours showed the significant differences as mean of reduction of VAS score (p=0.0069, 0.0165, 0.0058 respectively). Conclusion : The epidural PCA is more effective method to control the post-operative pain than IV PCA after 12 hours of spinal fusion operation. However, during the first twelve hours after operation, there were no differences between IV PCA and epidural PCA.
Keywords
Patient-controlled analgesia; Postoperative pain; Spinal fusion;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
Times Cited By Web Of Science : 0  (Related Records In Web of Science)
Times Cited By SCOPUS : 1
연도 인용수 순위
1 Matsui H, Kanamori M, Terahata N, Miaki K, Makiyama N, Satone T, et al. : Significance of patient-controlled analgesia in combination with continuous epidural block for patients who underwent posterior lumbar surgery. Eur Spine J 7 : 120-124, 1998   DOI   ScienceOn
2 Reuben SS, Connelly NR, Lurie S, Klatt M, Gibson CS : Dose-response of ketorolac as an adjunct to patient-controlled analgesia morphine in patients after spinal fusion surgery. Anesth Analg 87 : 98-102, 1998
3 Rockemann MG, Seeling W, Goertz AW, Konietzko I, Steffen P, Georgieff M : [Effectiveness, side effects and costs of postoperative pain therapy : intravenous and epidural patient-controlled analgesia (PCA)]. Anasthesiol Intensivmed Notfallmed Schmerzther 32 : 414-419, 1997   DOI
4 Schenk MR, Putzier M, Kugler B, Tohtz S, Voigt K, Schink T, et al. : Postoperative analgesia after major spine surgery : patient-controlled epidural analgesia versus patient-controlled intravenous analgesia. Anesth Analg 103 : 1311-1317, 2006   DOI   ScienceOn
5 Singelyn FJ, Gouverneur JM : Postoperative analgesia after total hip arthroplasty : i.v. PCA with morphine, patient-controlled epidural analgesia, or continuous "3-in-1" block? : a prospective evaluation by our acute pain service in more than 1,300 patients. J Clin Anesth 11 : 550-554, 1999   DOI   ScienceOn
6 Teng YH, Hu JS, Tsai SK, Liew C, Lui PW : Efficacy and adverse effects of patient-controlled epidural or intravenous analgesia after major surgery. Chang Gung Med J 27 : 877-886, 2004
7 Toussaint S, Maidl J, Schwagmeier R, Striebel HW : Patient-controlled intranasal analgesia : effective alternative to intravenous PCA for postoperative pain relief. Can J Anaesth 47 : 299-302, 2000   DOI   ScienceOn
8 Van Boerum DH, Smith JT, Curtin MJ : A comparison of the effects of patient-controlled analgesia with intravenous opioids versus epidural analgesia on recovery after surgery for idiopathic scoliosis. Spine (Phila Pa 1976) 25 : 2355-2357, 2000   DOI   ScienceOn
9 Cata JP, Noguera EM, Parke E, Ebrahim Z, Kurz A, Kalfas I, et al. : Patient-controlled epidural analgesia (PCEA) for postoperative pain control after lumbar spine surgery. J Neurosurg Anesthesiol 20 : 256-260, 2008   DOI   ScienceOn
10 Choi YS, Shim JK, Yoon do H, Jeon DH, Lee JY, Kwak YL : Effect of ramosetron on patient-controlled analgesia related nausea and vomiting after spine surgery in highly susceptible patients : comparison with ondansetron. Spine (Phila Pa 1976) 33 : E602-E606, 2008   DOI   ScienceOn
11 Cohen BE, Hartman MB, Wade JT, Miller JS, Gilbert R, Chapman TM : Postoperative pain control after lumbar spine fusion. Patient-controlled analgesia versus continuous epidural analgesia. Spine (Phila Pa 1976) 22 : 1892-1896; discussion 1896-1897, 1997   DOI   ScienceOn
12 Fisher CG, Belanger L, Gofton EG, Umedaly HS, Noonan VK, Abramson C, et al. : Prospective randomized clinical trial comparing patient-controlled intravenous analgesia with patient-controlled epidural analgesia after lumbar spinal fusion. Spine (Phila Pa 1976) 28 : 739-743, 2003
13 Jayr C, Beaussier M, Gustafsson U, Leteurnier Y, Nathan N, Plaud B, et al. : Continuous epidural infusion of ropivacaine for postoperative analgesia after major abdominal surgery : comparative study with i.v. PCA morphine. Br J Anaesth 81 : 887-892, 1998   DOI   ScienceOn
14 Fountas KN, Kapsalaki EZ, Johnston KW, Smisson HF 3rd, Vogel RL, Robinson JS Jr : Postoperative lumbar microdiscectomy pain. Minimalization by irrigation and cooling. Spine (Phila Pa 1976)24 : 1958-1960, 1999   DOI   ScienceOn
15 Garstka J, Mikolajczak G : [Patient-controlled analgesia (PCA) in postop pain management in scoliosis surgery]. Chir Narzadow Ruchu Ortop Pol 63 : 281-286, 1998
16 Hecker BR, Albert L : Patient-controlled analgesia : a randomized, prospective comparison between two commercially available PCA pumps and conventional analgesic therapy for postoperative pain. Pain 35 : 115-120, 1988   DOI   ScienceOn
17 Jo DJ, Jun JK, Kim KT, Kim SM : Lumbar interbody fusion outcomes in degenerative lumbar disease : comparison of results between patients over and under 65 years of age. J Korean Neurosurg Soc 48 : 412-418, 2010   DOI
18 Lebovits AH, Zenetos P, O'Neill DK, Cox D, Dubois MY, Jansen LA, et al. : Satisfaction with epidural and intravenous patient-controlled analgesia. Pain Med 2 : 280-286, 2001   DOI   ScienceOn
19 Bost P, Commun F, Albuisson E, Guichard C, Mom T, Eschalier A, et al. : [Postoperative pain assessment in head and neck cancer surgery : benefit of patient controlled analgesia (PCA)]. Ann Otolaryngol Chir Cervicofac 116 : 154-161, 1999
20 Zhao WP, Kawaguchi Y, Matsui H, Kanamori M, Kimura T : Histochemistry and morphology of the multifidus muscle in lumbar disc herniation : comparative study between diseased and normal sides. Spine (Phila Pa 1976) 25 : 2191-2199, 2000   DOI   ScienceOn