Korean J Anesthesiol.  2004 Sep;47(3):368-372. 10.4097/kjae.2004.47.3.368.

Comparison of Analgesic Effect and Satisfaction for Intravenous Patient-Controlled Analgesia and Epidural Patient-Controlled Analgesia in Patients Undergoing Cesarean Section with Spinal Anesthesia

• Kang TI
• Lee JH
• Ban JS
• Min BW

• KMID: 2299106
• DOI: http://doi.org/10.4097/kjae.2004.47.3.368

Abstract

BACKGROUND: In many cases, spinal anesthesia is performed in cesarean section. Many women want postoperative pain control. The purpose of this study was to compare the effects of intravenous patient-controlled analgesia (IV-PCA) and epidural patient-controlled analgesia (Epi-PCA) in patients undergoing cesarean section with spinal anesthesia.
METHODS
Forty healthy women were randomly assigned to receive IV-PCA or Epi-PCA after cesarean section with spinal anesthesia. The IV-PCA group received ketorolac 30 mg and butorphanol 0.5 mg intravenously when the peritoneum was sutured, followed by IV-PCA with 0.15% ketorolac and 0.005% butorphanol 100 ml (basal infusion rate 2 ml/hr, bolus 2 ml, lock-out time 15 mins). The Epi-PCA group received 0.01% morphine 10 ml via an epidural catheter when the peritoneum was sutured, followed by Epi-PCA with 0.004% morphine and 0.1% bupivacaine 100 ml (basal infusion rate 2 ml/hr, bolus 2 ml, lock-out time 15 mins). The degree of pain was subjectively evaluated using a visual analogue scale (VAS). Patients were evaluated at 2, 6, 12, 24 and 48 hours after operation. Statistical analyses were performed using T-test, Mann White U test and the Chi-square test.
RESULTS
VAS was not significantly different at any time, and the incidences of pruritus and sensory and motor changes of the lower extremities were significantly higher in Epi-PCA than IV-PCA.
CONCLUSIONS
Although VAS in the two groups was not significantly different, we conclude that IV-PCA is more beneficial than Epi-PCA in patients undergoing cesarean section with spinal anesthesia, because of the side effects of Epi-PCA.

Keyword

PCA; intravenous; epidural; cesarean section; spinal

MeSH Terms

Analgesia, Patient-Controlled*
Anesthesia, Spinal*
Bupivacaine
Butorphanol
Catheters
Cesarean Section*
Female
Humans
Incidence
Ketorolac
Lower Extremity
Morphine
Pain, Postoperative
Passive Cutaneous Anaphylaxis
Peritoneum
Pregnancy
Pruritus
Bupivacaine
Butorphanol
Ketorolac
Morphine