[Postoperative continuous epidural analgesia with portable disposable infuser pump: review of 1500 cases]

Abstract

Background: We have been offering active postoperative analgesia service (PAS). In order to further enhance the quality of PAS, we reviewed 1500 cases of postoperative continuous epidural analgesia (PCEA).

Methods: Postoperative patients received epidural administration of a mixed analgesic solution employing bupivacaine, morphine, or fentanyl using a portable disposable infuser pump (PDIP) for at least 72 hours. Analgesic effects were assessed by using Prince Henry's scoring and the demand for additional analgesics. The frequency and causes of discontinued infusion were also evaluated.

Results: 83.9% of cases showed no complications. However, in 4.7% of cases infusion was discontinued because of side effects (nausea, vomiting, pruritus, lower limb motor block, and hypotension, etc.), in 4.1% because of dislodgment of the epidural catheter, in 3.4% because of disconnection, in 2.0% because the patient removing the catheter, and in 0.8% because of the condition of the catheter insertion site.

Conclusion: These results indicate that to improve our method of PCEA with PDIP, we must re-assess our regimen used for continuous epidural infusion for postoperative pain relief, and develop measures to prevent side effects and complications.