• Asami Tomita, Makoto Satani, Akihiro Morimoto, Haruaki Ishibashi, and Yutaka Yonemura.
• Masui. 2015 Feb 1;64(2):208-11.

BackgroundWe investigated the efficacy of postoperative analgesia in peritonectomy for patients with peritoneal surface malignancy, by comparing peripheral nerve block (PNB) with intravenous patient controlled analgesia (iv-PCA) group to patient controlled epidural analgesia (PCEA) group.MethodsForty one patients of PNB+iv-PCA group received ultrasound guided rectus sheath block (using 0.25% levobupivacaine 20 ml bilaterally) and posterior transversus abdominis plane block (30 ml bilaterally) after induction of anesthesia. Then, iv-PCA with fentanyl was commenced before skin incision and 10 mg morphine was given 1 hr before the end of surgery. Fifty eight patients of PCEA group received 5-6 mg morphine epidural block at T6-7 or T7-8 before induction of anesthesia, and PCEA of 4-5 mg morphine and 200 ml normal saline was commenced before skin incision. When PCA showed inadequate effect for post- operative pain, flurbiprofen was used for all patients.ResultsThe rate of administration of flurbiprofen during the first 24 hr after surgery was significantly lower in PNB+iv-PCA group. The duration of the first administration of flurbiprofen after extubation was significantly longer in PNB+iv-PCA group. Levobupivacaine (0.25%) 100 ml for PNB was safe to use without complications.ConclusionsPNB+iv-PCA decreased the rate of administration of flurbiprofen as compared to PCEA for postoperative pain after peritonectomy.

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