• Hiroshi Saeki, Hiroshi Ishimura, Hidefumi Higashi, Dai Kitagawa, Junko Tanaka, Riichiroh Maruyama, Hidenori Katoh, Hirofumi Shimazoe, Kouta Yamauchi, Hitoshi Ayabe, Yoshihiro Kakeji, Masaru Morita, and Yoshihiko Maehara.
• Department of Surgery, Nippon Steel Yawata Memorial Hospital, Kitakyushu, Japan.
• Surg. Today. 2009 Jan 1;39(6):476-80.

PurposePatient-controlled epidural analgesia (PCEA) was developed for use after surgery for thoracic esophageal cancer to relieve wound pain, introduce early rehabilitation, and provide an uneventful postoperative recovery.MethodsThis retrospective study investigated 22 patients who underwent esophageal surgery to determine the efficacy of postoperative management with PCEA. In the PCEA group (n = 12), patients had two epidural catheters inserted to cover both the thoracic and abdominal incision with a patient-controlled bolus capability.ResultsPostoperative mechanical ventilation was administered in all cases in the control group (n = 10). On the other hand, this was only necessary in two patients in the PCEA group. The amount of time the patients stayed in the intensive care unit and the hospital was significantly shorter in the PCEA group than in the control group (P < 0.001 and P < 0.01, respectively). Respiratory complications occurred in four patients in the control group, and none in the PCEA group. The mean number of supplemental analgesics administered for breakthrough pain until the 7th postoperative day was 5.5 in the control group, and 1.3 in the PCEA group (P < 0.001).ConclusionsEarly rehabilitation is facilitated with intensive PCEA, while it also improves postoperative management and reduces hospitalization after esophageal surgery.

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