title: [Postoperative Analgesia in Peritonectomy for Patients with Peritoneal Surface Malignancy].
abstract: BACKGROUND
  We investigated the efficacy of postoperative analgesia in peritonectomy for patients with peritoneal surface malignancy, by comparing peripheral nerve block (PNB) with intravenous patient controlled analgesia (iv-PCA) group to patient controlled epidural analgesia (PCEA) group.
  
  
  METHODS
  Forty one patients of PNB+iv-PCA group received ultrasound guided rectus sheath block (using 0.25% levobupivacaine 20 ml bilaterally) and posterior transversus abdominis plane block (30 ml bilaterally) after induction of anesthesia. Then, iv-PCA with fentanyl was commenced before skin incision and 10 mg morphine was given 1 hr before the end of surgery. Fifty eight patients of PCEA group received 5-6 mg morphine epidural block at T6-7 or T7-8 before induction of anesthesia, and PCEA of 4-5 mg morphine and 200 ml normal saline was commenced before skin incision. When PCA showed inadequate effect for post- operative pain, flurbiprofen was used for all patients.
  
  
  RESULTS
  The rate of administration of flurbiprofen during the first 24 hr after surgery was significantly lower in PNB+iv-PCA group. The duration of the first administration of flurbiprofen after extubation was significantly longer in PNB+iv-PCA group. Levobupivacaine (0.25%) 100 ml for PNB was safe to use without complications.
  
  
  CONCLUSIONS
  PNB+iv-PCA decreased the rate of administration of flurbiprofen as compared to PCEA for postoperative pain after peritonectomy.
authors.forename: Asami
authors.initials: A
authors.lastname: Tomita
authors.forename: Makoto
authors.initials: M
authors.lastname: Satani
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morimoto
authors.forename: Haruaki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
mesh_terms: D016058:Analgesia, Patient-Controlled; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*