A prospective randomized trial comparing patient-controlled epidural analgesia to patient-controlled intravenous analgesia on postoperative pain control and recovery after major open gynecologic cancer surgery

2009 ◽  
Vol 114 (1) ◽  
pp. 111-116 ◽  
Author(s):  
Sarah E. Ferguson ◽  
Tim Malhotra ◽  
Venkatraman E. Seshan ◽  
Douglas A. Levine ◽  
Yukio Sonoda ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Randomized Trial ◽  
Pain Control ◽  
Gynecologic Cancer ◽  
Cancer Surgery ◽  
Prospective Randomized Trial ◽  
Postoperative Pain Control ◽  
Intravenous Analgesia

scholarly journals Efficacy of Continuous Epidural Analgesia versus Total Intravenous Analgesia on Postoperative Pain Control in Endovascular Abdominal Aortic Aneurysm Repair: A Retrospective Case-Control Study

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Ahmet Şen ◽  
Başar Erdivanlı ◽  
Abdullah Özdemir ◽  
Hızır Kazdal ◽  
Ersagun Tuğcugil
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Pain Control ◽  
Abdominal Aortic Aneurysm Repair ◽  
Postoperative Pain Control ◽  
Abdominal Aortic ◽  
Intravenous Analgesia ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

We reviewed our experience to compare the effectiveness of epidural analgesia and total intravenous analgesia on postoperative pain control in patients undergoing endovascular abdominal aortic aneurysm repair. Records of 32 patients during a 2-year period were retrospectively investigated. TIVA group (n=18) received total intravenous anesthesia, and EA group (n=14) received epidural anesthesia and sedation. Pain assessment was performed on all patients on a daily basis during rest and activity on postoperative days until discharge from ward using the numeric rating scale. Data for demographic variables, required anesthetic level, perioperative hemodynamic variables, postoperative pain, and morbidities were recorded. There were no relevant differences concerning hospital stay (TIVA group: 14.1 ± 7.0, EA group: 13.5 ± 7.1), perioperative blood pressure variability (TIVA group: 15.6 ± 18.1, EA group: 14.8 ± 11.5), and perioperative hemodynamic complication rate (TIVA group: 17%, EA group: 14%). Postoperative pain scores differed significantly (TIVA group: 5.4 ± 0.9, EA group: 1.8 ± 0.8,P<0.001). Epidural anesthesia and postoperative epidural analgesia better reduce postoperative pain better compared with general anesthesia and systemic analgesia, with similar effects on hemodynamic status.

scholarly journals Local infiltration vs epidural analgesia for postoperative pain control after total knee or hip arthroplasty

Medicine ◽  
2020 ◽  
Vol 99 (44) ◽  
pp. e22674
Author(s):  
Xian Liu ◽  
Haijing Zhang ◽  
Huan Zhang ◽  
Mengzhuo Guo ◽  
Yuanchao Gao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Hip Arthroplasty ◽  
Pain Control ◽  
Postoperative Pain Control ◽  
Local Infiltration ◽  
Total Knee

Epidural versus PCA Pain Management after Pectus Excavatum Repair: A Multi-Institutional Prospective Randomized Trial

2019 ◽  
Vol 30 (05) ◽  
pp. 465-471
Author(s):  
Joseph A. Sujka ◽  
Charlene Dekonenko ◽  
Daniel L. Millspaugh ◽  
Nichole M. Doyle ◽  
Benjamin J. Walker ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Length Of Stay ◽  
Minimally Invasive ◽  
Randomized Trial ◽  
Pain Control ◽  
Pectus Excavatum ◽  
Prospective Randomized Trial ◽  
Epidural Group ◽  
Thoracic Epidural ◽  
Pain Scores

Abstract Introduction Postoperative pain control remains the primary reason for inpatient stay after minimally invasive repair of pectus excavatum. In a previous study, our group reported that early pain control was better in patients managed with a thoracic epidural, while late pain control was better in patients managed with patient-controlled analgesia (PCA). After revising our epidural transition and modifying the PCA protocol, we conducted a multi-institutional prospective randomized trial to evaluate these two pain control strategies. Materials and Methods Patients were randomized to epidural or PCA following minimally invasive repair of pectus excavatum with standard protocols for each arm. Primary outcome was length of stay with secondary variables including mean patient pain scores, complications, and parental satisfaction. Scores were pooled for the two groups and reported as means with standard deviation. Results were compared using t-tests and one-way analysis of variance with p-value < 0.05 determining significance. Results Sixty-five patients were enrolled, 32 epidural and 33 PCA. Enrollment was stopped early when we developed an alternative strategy for controlling these patients' pain. There was no difference in length of stay in hours between the two arms; epidural 111.3 ± 18.5 versus PCA 111.4 ± 51.4, p = 0.98. Longer operative time was found in the epidural group. Nine patients in the epidural group (28%) required a PCA in addition to epidural for adequate pain control. Mean pain scores were lower on postoperative day 0 in the epidural group compared with the PCA groups, but were otherwise similar. Conclusion In our prospective randomized trial, PCA is just as effective as thoracic epidural in decreasing early postoperative pain scores after minimally invasive repair of pectus excavatum.

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