Comparison of perioperative outcomes for epidural versus intravenous patient-controlled analgesia after radical cystectomy

Regional Anesthesia and Pain Medicine
Andrew G WinerBernard H Bochner

Abstract

The use of patient-controlled epidural analgesia after various operations has been associated with an early return of bowel function, thus decreasing patients' length of stay (LOS). The primary aim of this study was to compare LOS after radical cystectomy between patients who received epidural analgesia versus those who received intravenous patient-controlled analgesia. Our secondary analysis included the assessment of other metrics such as total opioid requirements, pain scores, return of bowel function, and complication rates between the 2 groups. We conducted a retrospective review using the electronic medical records of 308 patients who underwent radical cystectomies at Memorial Sloan Kettering between 2006 and 2011. We aimed to understand if epidural analgesia was associated with a reduced LOS compared with patient-controlled intravenous opioid analgesia. We also aimed to identify performance improvements as a function of epidural analgesia status using various metrics such as pain management, bowel function return, and complication rates. We used both univariate and multivariate analyses to identify if epidural analgesia was associated with meaningful differences in the aforementioned metrics. Median age at radical cystec...Continue Reading

References

Jan 1, 1990·Digestive Diseases and Sciences·E H Livingston, E P Passaro
May 1, 1993·Journal of Clinical Anesthesia·J C BallantyneF Mosteller
Apr 20, 2002·Lancet·John R A RiggUNKNOWN MASTER Anaethesia Trial Study Group
Nov 13, 2003·JAMA : the Journal of the American Medical Association·Brian M BlockChristopher L Wu
Jul 30, 2009·Annals of Surgery·Pierre A ClavienMasatoshi Makuuchi

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Citations

Sep 19, 2015·Urology·Richard S MatulewiczJoshua J Meeks
Aug 20, 2015·Regional Anesthesia and Pain Medicine·Fu Shan XueRui Ping Li
Jun 9, 2020·Journal of Perioperative Practice·Tito D Tubog
Jan 14, 2021·Der Urologe. Ausg. A·G B SchulzB Schlenker
Dec 31, 2020·Anesthesiology·Vittoria Arslan-CarlonS Machele Donat

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