• Mei-Chi Lin, Jui-Yu Huang, Hsuan-Chih Lao, Pei-Shan Tsai, and Chun-Jen Huang.
• Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
• Acta Anaesthesiol Taiwan. 2010 Jun 1;48(2):68-74.

ObjectiveEpidural patient-controlled analgesia (EPCA) with a mixture of low-concentration levobupivacaine (0.0625% or 0.1%) plus fentanyl, with basal infusion, has been extensively used for postoperative analgesia in our allied institutions. To elucidate whether these two EPCA regimens provide satisfactory analgesia, we compared the analgesia efficacy and incidence of drug-related side effects for both EPCA regimens with those of the most widely used postoperative analgesia regimen, intra-venous PCA (IVPCA) with morphine.MethodsData collection was performed through retrospective chart review. A total of 335 patients who underwent colorectal surgery were included. Patients received IVPCA (n = 200), EPCA with 0.0625% levobupivacaine/fentanyl (n = 45), or EPCA with 0.1% levobupivacaine/fentanyl (n = 90). The analgesia efficacy and side effects were compared.ResultsPain scores with 0.0625% and 0.1% EPCA were significantly lower than those with IVPCA. Most patients were satisfied with their postoperative analgesia, and the satisfaction scores of these three groups were comparable. No patients developed respiratory depression or over-sedation. The incidence of nausea and vomiting was significantly higher with 0.1% EPCA (16.7% and 7.8%, respectively) compared with IVPCA (6.1% and 3.5%, respectively) and 0.0625% EPCA (9.3% and 2.3%, respectively). Moreover, the incidence of sensory and motor blockade was significantly higher with 0.1% EPCA (13.5% and 5.6%, respectively) than with 0.0625% EPCA (4.7% and 0%, respectively).ConclusionEpidural analgesia with low-concentration levobupivacaine plus fentanyl provides satisfactory postoperative analgesia with few side effects for patients after colorectal surgery.2010 Taiwan Society of Anesthesiologists. Published by Elsevier B.V. All rights reserved.

25 keywords...

hide…