Cost-effectiveness of analgesia after Caesarean section. A comparison of intrathecal morphine and epidural PCA

Acta Anaesthesiologica Scandinavica
M VercauterenH Adriaensen

Abstract

Patient-controlled analgesia (PCA) techniques and intrathecal morphine are the most widely used treatments for post-Caesarean section pain. However these methods have not been compared with respect to analgesic quality and cost differences. Fifty-three patients scheduled for elective or semi-urgent Caesarean section were randomized to receive for postoperative analgesia either epidural PCA with a mixture containing bupivacaine 0.06% and sufentanil 1 microg x ml(-1) or intrathecal morphine 0.15 mg together with the spinal anaesthetic and to be supplemented with paracetamol and tramadol. Analgesic efficacy, side-effects and costs were calculated during 48 h. VAS pain scores both at rest and during mobilization were lower in the PCA group, more particularly during the second postoperative day. Nausea and vomiting were more frequently registered in the morphine treated patients. PCA treated patients stayed longer in the recovery room but required fewer nurse interventions on the surgical ward. Manpower and drug costs were equal in both groups. The differences in total costs (Euro) amounted to euros 33 and were mainly caused by the more expensive equipment required for epidural PCA. Satisfaction and hospital discharge were similar f...Continue Reading

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Citations

Feb 27, 2004·Journal of Clinical Anesthesia·Krzysztof M Kuczkowski
May 24, 2005·Journal of Pain and Symptom Management·Klaus A Lehmann
Sep 25, 2012·Pain Research and Treatment·Borja Mugabure Bujedo
Oct 8, 2003·Best Practice & Research. Clinical Anaesthesiology·Wiebke Gogarten
May 22, 2010·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Krzysztof M Kuczkowski
Aug 29, 2003·Expert Opinion on Pharmacotherapy·Milo Engoren
Sep 30, 2004·Palliative Medicine·Lisa BakerUNKNOWN Tyneside Spinals Group
Feb 11, 2020·International Anesthesiology Clinics·Erica HollandChloe Zera
Mar 12, 2019·Current Pain and Headache Reports·Nalini VadiveluSusan Dabu-Bondoc
Apr 13, 2021·International Anesthesiology Clinics·Hon Sen TanAshraf S Habib

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