Perioperative Outcomes Comparing Patient Controlled Epidural Versus Intravenous Analgesia in Gynecologic Oncology Surgery.

Lee-May Chen
Vivian K Weinberg
Christine C. Chen MD, Lehigh Valley Health Network
C Bethan Powell
Lee-Lynn Chen
John K Chan
Daniel H Burkhardt

Abstract

OBJECTIVES: Our aim was to compare perioperative patient controlled epidural analgesia (PCEA) versus patient controlled intravenous analgesia (PCA) after gynecologic oncology laparotomy.

METHODS: This was a prospective cohort study where perioperative pain management was decided through patient-centered discussion by anesthesia and surgical teams. The study was designed to accrue 224 patients, to test for equivalence in pain control on postoperative day 1, defined as less than a 10% difference in the proportion of patients with a visual analog scale pain score of <2>(0-10 scale).

RESULTS: Two hundred forty patients were enrolled, with 205 patients evaluable for outcomes: 98 received PCA, while 107 received a thoracic level PCEA. Utilization of PCEA was associated with longer anesthesia time pre-op (means: 60 vs. 44 min, p

CONCLUSIONS: In this nonrandomized prospective study, selection of a PCEA for perioperative pain management did not improve pain management for patients undergoing gynecologic oncology surgery.