Survey of 1057 patients receiving postoperative patient-controlled epidural analgesia

Data were collected from 1057 consecutive patients who received patient-controlled epidural analgesia for postoperative pain relief, using 0.1% bupivacaine with 5 microg x ml(-1) fentanyl in all cases. Prescriptions were not otherwise standardised. On the first postoperative day, 741/801 patients (92.5%) had adequate analgesia and 692/719 (96.2%) were free of nausea. During a total of 3858 treatment days, two patients (0.19%) had an episode of severe respiratory depression and one patient (0.09%) became unrousable. Hypotension occurred in 45 patients (4.3%). There were no cases of epidural haematoma or abscess. We conclude that a patient-controlled epidural analgesia service as described is both efficacious and safe for use on surgical wards.