Assessment of effi cacy of patient-controlled epidural analgesia after nephrolithotomy and nephrectomy


Cite item

Full Text

Abstract

Patient-controlled epidural analgesia (PCEA) may provide effective postoperative analgesia after surgery. The main goal of our study was to assess the effi cacy and safety PCEA after nephrolithotomy and nephrectomy. We enrolled 60 adult patients. All patients have been divided on 2 groups. After surgery in the fi rst group (n=30) standard epidural analgesia 0,2% naropine with fentanyle 2 mkg/ml and adrenaline 2 mkg/ml was used. In the second group (n=30) we used PCEA 0,2% naropine with fentanyle 2 mkg/ml and adrenaline 2 mkg/ml with a lockout interval of 15 min, a continuous background infusion of 2 ml/h and bolus 4 ml. Pain scores were assessed in rest and coughing by 10-point visual analog scale (VAS) at 6, 12, 24 h. after ICU admission. In addition, the consumption of naropine and the incidence of adverse effects were recorded. Data were compared using Student’s t-test and x2 test. VAS was signifi cantly lower in second group. PCEA was more effective within the fi rst 24 hours.

About the authors

Воронежская областная клиническая больница №1

Author for correspondence.
Email: morozov@vmail.ru
доктор медицинских наук, заведующий отделением анестезиoлогии и реанимации №2 Воронежской областной клинической больницы № 1

Воронежская областная клиническая больница №1

Email: goncharova_eg@mail.ru
врач отделения анестезиологии и реанимации №2 Воронежской областной клинической больницы № 1

Воронежская государственная медицинская академия им. Н.Н.Бурденко

Email: admin@vestnik-surgery.com
доктор медицинских наук, профессор, заведующий кафедрой анестезиологии и реаниматологии ИПМО Воронежской государственной медицинской академии им. Н.Н.Бурденко

Воронежская областная клиническая больница №1

Email: eremina@mail.ru
врач отделения анестезиологии и реанимации №2 Воронежской областной клинической больницы № 1

References

  1. Breivik G. Posleoperatsionnaia epidural'naia analgeziia: sovremennoe sostoianie. Aktual'nye problemy anesteziologii i reanimatologii. Osvezhaiushchii kurs lektsii. Arkhangel'sk 2006: 106-113.
  2. Gorobets E.S., Goriaev R.V. Rassuzhdeniia o posleoperatsionnom obezbolivanii i vnedrenii epidural'noi analgezii v otechestvennuiu khirurgicheskuiu kliniku. Regionarnaia anesteziia i lechenie ostroi boli 2007; 1;1: 42-51.
  3. Ovechkin A.V. Gnezdilov, M.L. Kukushkin i soavt. Profilaktika posleoperatsionnoi boli, patogeneticheskie osnovy i klinicheskoe primenenie. Anesteziologiia i reanimatologiia 2000; 5: 71-76.
  4. Ovechkin A.M., Romanova T.L. Posleoperatsionnoe obezbolivanie: optimizatsiia podkhodov s tochki zreniia dokazatel'noi meditsiny. Russkii meditsinskii zhurnal 2006; 14: 10: 3-10.
  5. Ovechkin A.M., Romanova T.L. Spinal'naia i epidural'naia anesteziia v khirurgii: klinicheskoe znachenie i vliianie na iskhod lecheniia. Regionarnaia anesteziia i lechenie ostroi boli 2006; 1: 16-23.
  6. A Lin E.E., Liu S.S. Effi cacy of postoperative patientcontrolled and continuous infusion epidural analgesia versus intravenous patient-controlled analgesia with opioids: A meta-analysis. Anesthesiology 2005; 103: 1079-1088
  7. Berti M., Casati A., Fanelli G. et al. 0.2% ropivacaine with of without fentanyl for patient-controlled epidural analgesia after major abdominal surgery: a double-blind study. J.Clin. Anesth.2000.Jun.; 12(4):292-297.
  8. Eugune R., Viscusi D.M. Patient-control drug delivery for acute postoperative pain managrment: A review of current and emerging technologies. Regina anesthesia and pain medicine 2008; 33: 2: 146-158
  9. Momeni M, Crucitti M., De K.M. Patient-controlledanalgesia in the management of postoperative pain. Drugs 2006; 66: 2321-2337.
  10. Yu P.Y., Gambling D.R. A comparative study of patientcontrolled
  11. epidural fentanyl and single dose epidural morphine for post-caesarean analgesia. Can J Anaesth 1993; 40: 416-420.
  12. Wu C.L., Cohen S.R., Richman J.M. et al. Effi cacy of postoperative epidural analgesia: A meta-analysis. JAMA 2003; 290: 2455-2463.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2010 ., ., ., .

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies