the Postoperative Pain Control for the Benign Prostatic Hypertrophy: Continuous Epidural Pain Block versus Intravenous Patient - Controlled Analgesia

Park, Sun Gyoo; Kim, Jin Yun; Rah, Eun Gil

Abstract

BACKGROUND: Postoperative bleeding is a common complication in transurethral tesection of prostate (TURP). Some patients become restless and combative after operation, particularly when in pain, producing bleeding from the prostatic bed. So many patients may be necessary to pain control for reduce bleeding. The purpose of this study is to compare recently used two methods for post-operative analgesia.
METHODS
We studied 40 patients, ASA physical staus 1, 2, undergone TURP under general anesthesia. The patients divided into two groups: continuous epidural pain control group g, n=20) received an epidural bolus of morphine 2 mg and 1% lidocaine 10 ml followed by a epidural 0.08% bupivacaine 40 ml and morphine 4.5 mg (basal infusian rate 0.5 ml/hr), intravenous patient-controlled analgesia (IV-PCA) group (II, n=20) received an intravenous bolus of fentanyl 50-100 microgram followed by a IV-PCA morphine 30 mg, ketorolac 180 mg and droperdol 2.5 mg (basal infusion rate 0.5 ml/hr, bolus 0.5 ml, lock-out interval 15 min). This study conducted the analgesic efficacy, side effect and patient's satisfaction for 1 day after TURP.
RESULTS
Continuous epidural pain control group had more significant analgesia than IV-PCA at postoperative 30, 60 min, but no significant difference was observed later in both group. Nausea and pruritus were scantly developed in both group but the incidence was no significant differeance. Patients responded good satisfaction over 70% in both group.
CONCLUSIONS
Postoperative continuous epidural pain block and IV-PCA are both effective methods of postoperative pain control with lower incidence of side effects.