• Robert B Steinberg, Spencer S Liu, Christopher L Wu, David C Mackey, Jeffrey A Grass, Kjell Ahlén, and Lennart Jeppsson.
• Department of Anesthesiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, USA.
• J Clin Anesth. 2002 Dec 1;14(8):571-7.

Study ObjectiveTo compare the effects of ropivacaine-fentanyl patient-controlled epidural analgesia (PCEA) with morphine intravenous (IV) patient-controlled analgesia (PCA).DesignProspective, randomized, multicenter trial.SettingFive university-affiliated hospitals.Patients41 patients undergoing colon surgery.InterventionPatients were randomized to receive either standardized combined epidural/general anesthesia followed by PCEA with ropivacaine 0.2% and fentanyl (2 microg/mL) or standardized general anesthesia followed by morphine IV PCA. All patients participated in a standardized postoperative clinical pathway.Measurements And Main ResultsAnalgesia was assessed with visual analog scale (VAS) scores. Postoperative recovery was assessed by completion of prospectively defined discharge milestones and time until discharge. Statistical analyses included nonparametric and contingency table analyses. The PCEA group had better analgesia (> 50% reduction in pain scores, assessed both at rest and during a cough) for the first 3 days after surgery (p < 0.0,005). The PCEA group achieved discharge milestones approximately 36 hours faster (p < 0.002), but time until discharge was similar between groups.ConclusionsRopivacaine-fentanyl PCEA provides superior analgesia, reduced opioid requirement, and more rapid recovery after colon surgery.

30 keywords...

hide…