[The effects of patient-controlled epidural analgesia with background infusion after abdominal surgery]

Although patient-controlled epidural analgesia (PCEA) is widely known to provide good pain control after abdominal surgery, it has not been popular in Japan. We evaluated the effects of PCEA with background infusion after major abdominal surgery.

Ninety patients scheduled for abdominal surgery were randomly allocated to two groups by treatment with postoperative epidural analgesia: infuser group (n = 48); continuous infusion 5 ml.hr-1 or PCEA group (n = 42); background infusion 5 ml.hr-1, PCEA 3 ml and lock out 30 min. Microject (Sorenson Medical Co, U.S.A.) was used for PCEA machine. 0.2% ropivacaine 100 ml with fentanyl 500 micrograms was administered into the epidural space in both groups.

Postoperative visual analogue scale (VAS) at rest and coughing were about 10 mm and 40 mm in both group, respectively, and there were no significant differences between the groups. NSAIDs were effective for rescue analgesia in infuser group to improve postoperative pain as PCEA. Vomiting and sedation were more frequent in infuser group than in PCEA group. Empty battery and machine troubles of unknown origin were observed in 2 and 4 patients, respectively in PCEA group.

PCEA with background infusion could improve the management of postoperative pain, and adequate program of PCEA is important to reduce postoperative pain and its side effects.