PMID: 8948744Jul 1, 1995Paper

Patient-controlled postoperative analgesia in orthopedic surgery: epidural PCA versus intravenous PCA

Minerva anestesiologica
L BertiniL Rossignoli

Abstract

To evaluate both effectiveness and incidence of side effects of two techniques of postoperative pain treatment: intravenous and epidural PCA. Prospective analysis of data from two groups of randomized patients. Orthopedic and trauma center. Figty ASA class II-III patients undergoing total hip replacement under combined Spinal-Epidural Anesthesia. Patients were divided into 2 groups who received different postoperative pain treatment. One group (group PCA) received a patient-controlled intravenous analgesia with morphine 30 mg and ketorolac 90 mg in 100 ml of saline (back-ground infusion 2-4 ml, according to body weith, bolus 1 ml, lockout 5 min, 4 h dose limit 40 ml). PCEA group received a patient-controlled epidural analgesia with morphine 4 mg and bupivacaine 0.125% 100 ml, (background infusion 3-4 ml, according to patient' height, bolus 1 ml, lockout 10 min, 4 h dose limit 25 ml). Postoperative pain intensity was evaluated, through 24 postoperative hours, by a verbal analogue scale (VPS = 0 to 3) and a total pain score (TOTPAR) was calculated for each patient at 6 and 24 postoperative hours. Side effects were recorded and their incidence was obtained for each group. Statistical data analysis was performed by one-way ANOVA an...Continue Reading

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