title: Audit of a ward-based patient-controlled epidural analgesia service in Ireland.
abstract: BACKGROUND
  Ward-based patient-controlled epidural analgesia (PCEA) for postoperative pain control was introduced at our institution in 2006. We audited the efficacy and safety of ward-based PCEA from January 2006 to December 2008.
  
  
  METHODS
  Data were collected from 928 patients who received PCEA in general surgical wards for postoperative analgesia using bupivacaine 0.125% with fentanyl 2 μg/mL.
  
  
  RESULTS
  On the first postoperative day, the median visual analogue pain score was 2 at rest and 4 on activity. Hypotension occurred in 21 (2.2%) patients, excessive motor blockade in 16 (1.7%), high block in 5 (0.5%), nausea in 5 (0.5%) and pruritus in only 1 patient. Excessive sedation occurred in two (0.2%) patients but no intervention was required. There were no serious complications such as epidural abscess, infection or haematoma.
  
  
  CONCLUSIONS
  Effective and safe postoperative analgesia can be provided with PCEA in a general surgical ward without recourse to high-dependency supervision.
authors.affiliation: Department of Anaesthesia and Perioperative Medicine, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland. tutan@me.com
authors.forename: T
authors.initials: T
authors.lastname: Tan
authors.forename: D
authors.initials: D
authors.lastname: Wilson
authors.forename: A
authors.initials: A
authors.lastname: Walsh
authors.forename: P
authors.initials: P
authors.lastname: Hu
authors.forename: C
authors.initials: C
authors.lastname: Power
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D000779:Anesthetics, Local / Q000627:therapeutic use; D002045:Bupivacaine / Q000627:therapeutic use; D054869:Clinical Audit; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine