Checkpoints for the Better Management of Patients Undergoing Intravenous Patient-Controlled Analgesia (IV-PCA) or Patient-Controlled Epidural Analgesia (PCEA)

Objective: To evaluate the efficacy and safety of patient-controlled analgesia through prolonged epidural analgesia after joint replacement of the lower extremities. Material and methods. We analyzed the postoperative period of 213 elderly and senile patients who were operated on for degenerative-dystrophic and traumatic injuries of the joints of the lower extremities. All patients underwent total joint replacement (164 - THA and 49 - TKA). The age of patients is from 65 to 90 years (average age was 78 ± 8 years) with a physical status of ASA 3 and above. All examined patients were divided into 2 groups. 63 patients comprised the main group, which in the postoperative period underwent patient-controlled analgesia (PCA) through prolonged epidural analgesia. The control group consisted of 150 patients, for the anesthesia of which in the postoperative period only standard systemic multimodal analgesia was used Conclusion. Patient-controlled analgesia is an alternative to traditional analgesic regimens. This method should be one of the main methods after surgical anesthesia for joint replacement of the lower limb in elderly and senile patients.

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Patient controlled analgesia versus patient controlled epidural analgesia for postoperative pain management in elderly patients

Regional Anesthesia and Pain Medicine ◽

10.1016/j.rapm.2005.07.056 ◽

2005 ◽

Vol 30 (5) ◽

pp. 34-34

Author(s):

C KRISTOLOBEANOU ◽

S HADZILIA ◽

A LOUIZOS ◽

A KRANA ◽

I KOUROUKLI ◽

...

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Elderly Patients ◽

Epidural Analgesia ◽

Postoperative Pain Management ◽

Patient Controlled Analgesia

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Superior postoperative pain relief with thoracic epidural analgesia versus intravenous patient-controlled analgesia after minimally invasive pectus excavatum repair

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2007.05.050 ◽

2007 ◽

Vol 134 (4) ◽

pp. 865-870 ◽

Cited By ~ 62

Author(s):

Thomas Weber ◽

Johanna Mätzl ◽

Alexander Rokitansky ◽

Walter Klimscha ◽

Konrad Neumann ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Relief ◽

Minimally Invasive ◽

Epidural Analgesia ◽

Pectus Excavatum ◽

Thoracic Epidural Analgesia ◽

Postoperative Pain Relief ◽

Patient Controlled Analgesia ◽

Thoracic Epidural

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Patient-Controlled Epidural Analgesia in Labour — is a Continuous Infusion of Benefit?

Anaesthesia and Intensive Care ◽

10.1177/0310057x9202000103 ◽

1992 ◽

Vol 20 (1) ◽

pp. 15-20 ◽

Cited By ~ 61

Author(s):

M. J. Paech

Keyword(s):

Side Effects ◽

Epidural Analgesia ◽

Patient Controlled Analgesia ◽

Self Administration ◽

High Quality ◽

Active Labour ◽

Background Infusion ◽

Significant Difference ◽

Continuous Background ◽

Single Blind

A randomised, single-blind study was conducted among 52 gravida in active labour, to investigate two variants of patient-controlled epidural analgesia — bolus only versus bolus plus infusion. Patient-controlled analgesia variables, using an epidural solution of 0.125% bupivacaine plus fentanyl 3 mcg per ml, were a 4 ml incremental bolus with 15 minute lockout, plus or minus a 4 ml per hour infusion. Up to three additional staff-administered supplements of 0.5% bupivacaine 4 ml (20 mg) were allowed. There was no significant difference between groups with respect to pain relief, supplementary boluses required, satisfaction, side-effects or details of patient-controlled epidural analgesia, with the exception of greater fentanyl usage in the bolus plus infusion group (P < 0.003). Both groups had high quality analgesia, low rates of bupivacaine usage and were highly satisfied. However, under the conditions of the study, the addition of a continuous background infusion to self-administration conferred no benefit.

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