Audit of a ward-based patient-controlled epidural analgesia service in Ireland.
AffiliationDepartment of Anaesthesia and Perioperative Medicine, Coombe Women and Infants, University Hospital, Cork Street, Dublin 8, Ireland. firstname.lastname@example.org
*Analgesia, Epidural/adverse effects
*Analgesia, Patient-Controlled/adverse effects
Anesthetics, Local/therapeutic use
Pain, Postoperative/*drug therapy
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CitationIr J Med Sci. 2011 Jun;180(2):417-21. Epub 2010 Nov 23.
JournalIrish journal of medical science
AbstractBACKGROUND: Ward-based patient-controlled epidural analgesia (PCEA) for postoperative pain control was introduced at our institution in 2006. We audited the efficacy and safety of ward-based PCEA from January 2006 to December 2008. METHOD: Data were collected from 928 patients who received PCEA in general surgical wards for postoperative analgesia using bupivacaine 0.125% with fentanyl 2 mug/mL. RESULTS: On the first postoperative day, the median visual analogue pain score was 2 at rest and 4 on activity. Hypotension occurred in 21 (2.2%) patients, excessive motor blockade in 16 (1.7%), high block in 5 (0.5%), nausea in 5 (0.5%) and pruritus in only 1 patient. Excessive sedation occurred in two (0.2%) patients but no intervention was required. There were no serious complications such as epidural abscess, infection or haematoma. CONCLUSION: Effective and safe postoperative analgesia can be provided with PCEA in a general surgical ward without recourse to high-dependency supervision.