Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical Surgery2070-478X2409-143XVoronezh State Medical University46410.18499/2070-478X-2010-3-4-415-417UnknownAssessment of effi cacy of patient-controlled epidural analgesia after nephrolithotomy and nephrectomymorozov@vmail.rugoncharova_eg@mail.ruadmin@vestnik-surgery.comeremina@mail.ru24122010344154170205201602052016Copyright © 2010, ., ., ., .2010Patient-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.epidural blockadepatient-controlled analgesianaropineэпидуральная блокадаконтролируемая пациентом аналгезиянаропин[Breivik G. Posleoperatsionnaia epidural'naia analgeziia: sovremennoe sostoianie. Aktual'nye problemy anesteziologii i reanimatologii. Osvezhaiushchii kurs lektsii. Arkhangel'sk 2006: 106-113.][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.][Ovechkin A.V. Gnezdilov, M.L. Kukushkin i soavt. Profilaktika posleoperatsionnoi boli, patogeneticheskie osnovy i klinicheskoe primenenie. Anesteziologiia i reanimatologiia 2000; 5: 71-76.][Ovechkin A.M., Romanova T.L. Posleoperatsionnoe obezbolivanie: optimizatsiia podkhodov s tochki zreniia dokazatel'noi meditsiny. Russkii meditsinskii zhurnal 2006; 14: 10: 3-10.][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.][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][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.][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][Momeni M, Crucitti M., De K.M. Patient-controlledanalgesia in the management of postoperative pain. Drugs 2006; 66: 2321-2337.][Yu P.Y., Gambling D.R. A comparative study of patientcontrolled][epidural fentanyl and single dose epidural morphine for post-caesarean analgesia. Can J Anaesth 1993; 40: 416-420.][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.][2463.]