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Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery.
Anesth Analg. 1992 Aug; 75(2):245-51.A&A

Abstract

Epidural administration of an opioid analgesic by means of a patient-controlled analgesia (PCA) system was compared with conventional intravenous PCA for pain relief after cesarean delivery. One hundred seventeen healthy women were randomly assigned to receive hydromorphone either intravenously (IV-PCA) or epidurally (EPI-PCA) after cesarean delivery with epidural bupivacaine for operative anesthesia. The hydromorphone requirements were 3.4 and 4.2 times more in the IV-PCA group on the first (P less than 0.01) and second (P less than 0.01) postoperative days, respectively. The mean number (+/- SD) of PCA demands during the first 24 h after the operation was 105 (+/- 88) for the IV-PCA group and 33 (+/- 48) for the EPI-PCA group (P less than 0.01). This difference was also significant 24-48 h after surgery. Although the EPI-PCA group utilized significantly less opioid medication, pain and sedation scores were similar in the two treatment groups; however, a significantly larger percentage of patients in the IV-PCA group (46% vs 22%) stated that they felt drowsy during the first postoperative day. Pruritus was reported more frequently in the EPI-PCA (67%) than in the IV-PCA (33%) group. Nausea was experienced by only 10% of patients in the IV-PCA and 6% in the EPI-PCA group. There was no evidence of postoperative respiratory depression, with minimal oxygen saturation values of 93% (+/- 3%) and 94% (+/- 1%) in the IV-PCA and EPI-PCA groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Parker RK
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
White PF
No affiliation info available

MeSH

AdultAnalgesia, EpiduralAnalgesia, ObstetricalAnalgesia, Patient-ControlledAnesthesia Recovery PeriodAnesthesia, EpiduralBupivacaineCesarean SectionFemaleHumansHydromorphoneInjections, IntravenousPain, PostoperativePregnancyProspective Studies

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1378707

Citation

Parker, R K., and P F. White. "Epidural Patient-controlled Analgesia: an Alternative to Intravenous Patient-controlled Analgesia for Pain Relief After Cesarean Delivery." Anesthesia and Analgesia, vol. 75, no. 2, 1992, pp. 245-51.
Parker RK, White PF. Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery. Anesth Analg. 1992;75(2):245-51.
Parker, R. K., & White, P. F. (1992). Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery. Anesthesia and Analgesia, 75(2), 245-51.
Parker RK, White PF. Epidural Patient-controlled Analgesia: an Alternative to Intravenous Patient-controlled Analgesia for Pain Relief After Cesarean Delivery. Anesth Analg. 1992;75(2):245-51. PubMed PMID: 1378707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery. AU - Parker,R K, AU - White,P F, PY - 1992/8/1/pubmed PY - 1992/8/1/medline PY - 1992/8/1/entrez SP - 245 EP - 51 JF - Anesthesia and analgesia JO - Anesth Analg VL - 75 IS - 2 N2 - Epidural administration of an opioid analgesic by means of a patient-controlled analgesia (PCA) system was compared with conventional intravenous PCA for pain relief after cesarean delivery. One hundred seventeen healthy women were randomly assigned to receive hydromorphone either intravenously (IV-PCA) or epidurally (EPI-PCA) after cesarean delivery with epidural bupivacaine for operative anesthesia. The hydromorphone requirements were 3.4 and 4.2 times more in the IV-PCA group on the first (P less than 0.01) and second (P less than 0.01) postoperative days, respectively. The mean number (+/- SD) of PCA demands during the first 24 h after the operation was 105 (+/- 88) for the IV-PCA group and 33 (+/- 48) for the EPI-PCA group (P less than 0.01). This difference was also significant 24-48 h after surgery. Although the EPI-PCA group utilized significantly less opioid medication, pain and sedation scores were similar in the two treatment groups; however, a significantly larger percentage of patients in the IV-PCA group (46% vs 22%) stated that they felt drowsy during the first postoperative day. Pruritus was reported more frequently in the EPI-PCA (67%) than in the IV-PCA (33%) group. Nausea was experienced by only 10% of patients in the IV-PCA and 6% in the EPI-PCA group. There was no evidence of postoperative respiratory depression, with minimal oxygen saturation values of 93% (+/- 3%) and 94% (+/- 1%) in the IV-PCA and EPI-PCA groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/1378707/Epidural_patient_controlled_analgesia:_an_alternative_to_intravenous_patient_controlled_analgesia_for_pain_relief_after_cesarean_delivery_ DB - PRIME DP - Unbound Medicine ER -