Efficacy of postoperative patient-controlled and continuous infusion epidural analgesia versus intravenous patient-controlled analgesia with opioids: A meta-analysis

Christopher L. Wu, Seth R. Cohen, Jeffrey M. Richman, Andrew J. Rowlingson, Genevieve E. Courpas, Kristin Cheung, Elaina E. Lin, Spencer S. Liu

Research output: Contribution to journalReview articlepeer-review

Abstract

The authors performed a meta-analysis and found that epidural analgesia overall provided superior postoperative analgesia compared with intravenous patient-controlled analgesia. For all types of surgery and pain assessments, all forms of epidural analgesia (both continuous epidural infusion and patient-controlled epidural analgesia) provided significantly superior postoperative analgesia compared with intravenous patient-controlled analgesia, with the exception of hydrophilic opioid-only epidural regimens. Continuous epidural infusion provided statistically significantly superior analgesia versus patient-controlled epidural analgesia for overall pain, pain at rest, and pain with activity; however, patients receiving continuous epidural infusion had a significantly higher incidence of nausea-vomiting and motor block but lower incidence of pruritus. In summary, almost without exception, epidural analgesia, regardless of analgesic agent, epidural regimen, and type and time of pain assessment, provided superior postoperative analgesia compared to intravenous patient-controlled analgesia.

Original languageEnglish (US)
Pages (from-to)1079-1088+1109-1110
JournalAnesthesiology
Volume103
Issue number5
DOIs
StatePublished - Nov 2005

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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