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Evidence summaries

Patient Controlled Intravenous Opioid Analgesia Vs. Continuous Epidural Analgesia for Pain after Intra-Abdominal Surgery

Continuous epidural analgesia is superior to intravenous opioid patient-controlled analgesia in relieving postoperative pain for up to 72 hours after abdominal surgery. Level of evidence: "A"

A Cochrane review [Abstract] 1 [withdrawn from publication] included nine studies with a total of 711 subjects. The patient-controlled analgesia (PCA) group had a higher pain visual analogue scale than the continuous epidural analgesia (CEA) group during 6, 24 and 72 hour periods. The weighted mean difference and 95% confidence interval of resting pain was 1.74 (95% CI 1.30 to 2.19), 0.99 (95% CI 0.65 to 1.33), and 0.63 (95% CI 0.24 to 1.01), respectively. The length of hospital stay and other adverse effects were not statistically different except that the incidence of pruritus was lower in the PCA group, odds ratio of 0.27 (95% CI 0.11 to 0.64).

    References

    • Werawatganon T, Charuluxananan S. WITHDRAWN: Patient controlled intravenous opioid analgesia versus continuous epidural analgesia for pain after intra-abdominal surgery. Cochrane Database Syst Rev 2013;(3):CD004088. [PubMed]

Primary/Secondary Keywords