title: [Effectiveness of low dose PCEA for postoperative pain after laparoscopic gynecological surgeries--a comparison of laparoscopic ovarian cystectomy and myomectomy].
abstract: BACKGROUND
  We evaluated the effectiveness of low-dose patient-controlled epidural analgesia (PCEA) in the patients undergoing laparoscopic gynecological surgery, and investigated the difference of postoperative pain between patients for laparoscopic ovarian cystectomy and those for myomectomy.
  
  
  METHODS
  Thirteen patients (ASA PS 1 or 2), scheduled for laparoscopic surgery, were enrolled in this study. They were divided into two groups of ovarian cystectomy (group C, n=17) and myomectomy (group M, n=13). After administering epidural bolus of 0.2% ropivacaine 6 ml, droperidol 2.5 mg, and buprenorphine hydrochloride 0.1 mg, PCEA was started: 1 ml x hr(-1) background infusion; 0.2% ropivacaine 54 ml, droperidol 5 mg, and buprenorphine hydrochloride 0.3 mg; 1 ml epidural bolus with a 30-minute lockout interval. We evaluated postoperative pain using visual analogue scale (VAS) at rest and on movement, adverse effects such as respiratory and cardiovascular depression, nausea and vomiting for 48 hours after surgery.
  
  
  RESULTS
  VAS at rest with group M was significantly higher than that of group C (11 +/- 2 vs. 6 +/- 2, P=0.048), and VAS on movement of group M was also higher than that of group C (25 +/- 3 vs. 18 +/- 2, P=0.023): however, we found good analgesic effect of less than VAS 3 in both groups. Severe adverse effects were not observed.
  
  
  CONCLUSIONS
  These findings suggest that low dose PCEA is effective for patients who undergo laparoscopic gynecological surgery.
authors.affiliation: Takasaki Pain Clinic, Takasaki 370-0035.
authors.forename: Keiko
authors.initials: K
authors.lastname: Shimohata
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Shimohata
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ikeda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Tetsu
authors.initials: T
authors.lastname: Ono
authors.forename: Ryoichiro
authors.initials: R
authors.lastname: Motegi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ishikura
authors.forename: Masashi
authors.initials: M
authors.lastname: Sato
authors.forename: Kou
authors.initials: K
authors.lastname: Miyashita
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects / Q000379:methods*; D002047:Buprenorphine / Q000008:administration & dosage; D004329:Droperidol / Q000008:administration & dosage; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D010048:Ovarian Cysts / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy*; D000077212:Ropivacaine
chemical_list: D000577:Amides; D002047:Buprenorphine; D000077212:Ropivacaine; D004329:Droperidol