Anesthesia

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Is Intravenous Patient Controlled Analgesia Enough for Pain Control in Patients Who Underwent Thoracoscopy?
Journal of Korean Medical Science, 10/01/09

Kim JA et al. – Epidural patient–controlled analgesia (Epidural PCA) and intravenous patient–controlled analgesia (IV PCA) are equally effective to control the postoperative pain after VATS lobectomy, which suggests that IV PCA may be used instead of Epidural PCA.

• Prospective randomized study.
• 52 patients scheduled for VATS lobectomy were randomly allocated into two groups: an Epidural PCA group receiving an epidural infusion of ropivacaine 0.2%+fentanyl 5 microg/mL combination at a rate of 4 mL/hr, and an IV PCA group receiving an intravenous infusion of ketorolac 0.2 mg/kg+fentanyl 15 microg/mL combination at a rate of 1 mL/hr.
• Pain scores were then recorded using the visual analogue scale at rest and during motion (VAS–R and VAS–M, 0–10) for five days following surgery.
• In addition, the authors measured the daily morphine consumption, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), satisfaction score, and the incidence of side effects.

• 37 patients out of 52 completed the study (18 in the Epidural PCA group, 19 in the IV PCA group).
• There were no differences in the pain scores, analgesic requirements, pulmonary function, satisfaction score, and the incidence of side effects between groups.

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