Continuous regional analgesia in comparison with intravenous opioid administration for routine postoperative pain control.
This study compares retrospectively the postoperative analgesia provided via intravenous opioids with continuous regional techniques (interpleural and epidural infusions) administered as a clinical routine by an anaesthesia-based Acute Pain Service. In 2630 patients no severe complications resulting in morbidity or mortality occurred; the rate of potentially serious complications was in the 0.5% range and comparable between the techniques. A detailed analysis of a randomised subsample of 340 patients revealed better analgesia at rest and better compliance with physiotherapy under continuous regional analgesia. Techniques of continuous regional analgesia also resulted in fewer incidents of desaturation and fewer side effects. Patient satisfaction with these techniques was higher than with intravenous opioid administration. In conclusion, continuous regional analgesia in a routine clinical setting is comparable to intravenous opioid administration with regard to safety, but results in significantly better analgesia with fewer side effects.
Department of Pharmacology and Clinical Pharmacology, School of Medicine, University of Auckland, New Zealand.
S A
SA
Schug
R A
RA
Fry
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000009:adverse effects; D016058:Analgesia, Patient-Controlled; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy*; D017060:Patient Satisfaction; D010994:Pleura; D012189:Retrospective Studies
D009020:Morphine; D002045:Bupivacaine