Postoperative epidural analgesia often needs rate readjustment using top-ups. Patient-controlled epidural analgesia (PCEA) is said to reduce the requirement of epidural top-ups when compared to continuous epidural analgesia (CEA). We compared CEA and PCEA in major thoracic and abdominal surgery, in a cohort study. The primary endpoint was the required number of epidural top-ups. Secondary endpoints were pain scores, side effects and workload differences. We analysed 199 patients with CEA and 187 with PCEA. Both groups had similar pain scores. The total number of top-ups was 75 in 57 patients (CEA) versus 20 top-ups in 18 patients (PCEA). (p = 0.0001) Sedation tended to occur more frequently in patients with CEA versus PCEA, 5.5% vs 1.6% (p = 0.05). Implementation of PCEA led to a decreased number of top-ups, fewer side-effects and decreased use of the postoperative care unit.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646815PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186225PLOS

Publication Analysis

Top Keywords

epidural analgesia
16
number top-ups
12
patients cea
12
cohort study
8
epidural top-ups
8
pain scores
8
top-ups patients
8
cea versus
8
top-ups
7
epidural
6

Similar Publications

Objective: In part I, measure the EC50 of sufentanil in obese and non-obese parturients combined with 0.1% ropivacaine and compare the differences. Similarly, in part II, measure the EC50 of ropivacaine in obese and non-obese parturients combined with 0.

View Article and Find Full Text PDF

Objective: There is a lack of research on epidural esketamine for labor analgesia. The purpose of this research is to compare the efficacy of epidural esketamine and sufentanil on labor analgesia and postpartum depression.

Methods: A total of 187 cephalic full-term parturients with single-fetus vaginal delivery were collected in this retrospective study from Jan 2022 to Jan 2023.

View Article and Find Full Text PDF

: Esophagectomy is a key component of esophageal cancer treatment, with minimally invasive esophagectomy (MIE) increasingly replacing open esophagectomy (OE). Effective postoperative pain management can be achieved through various analgesic modalities. This study compares the efficacy of thoracic epidural anesthesia (TEA) with non-TEA methods in managing postoperative pain following MIE.

View Article and Find Full Text PDF

Background: Obstetric lesions of the anal sphincter (OASIS) are tears intersecting the structure of the anus after vaginal delivery. Our aim is to provide data on the incidence of OASIS and investigate potentially connected risk factors.

Methods: This is a retrospective analysis of 464 parturient patients admitted to the AOU Maggiore della Carità, Novara (Italy), in the last ten years (2013-2023), comparing 116 cases (with OASIS) versus 348 controls (with no OASIS).

View Article and Find Full Text PDF

Postdural puncture headache: Beyond the evidence.

Best Pract Res Clin Anaesthesiol

September 2024

Yale Medicine/Yale New Haven Health System, USA. Electronic address:

Despite advances in procedural techniques and equipment, postdural puncture headache (PDPH) remains a serious complication of labour epidural analgesia after accidental dural puncture (ADP). Often considered a temporary inconvenience, PDPH can be debilitating in the short term. It can also be associated with chronic manifestations and serious complications.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!