Comparison of analgesic efficacy of continuous epidural infusion versus patient-controlled epidural analgesia with bupivacaine and fentanyl after abdominal hysterectomy / Samaa Wageh Salem ; supervised Nadia Youssef Hamed Helmy , Nesrine Abdelrahman Elrefai , Ahmed Ibrahim Elsakka

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Introduction: The provision of high-quality analgesia in the postoperative period is important, not only to relieve post-surgical pain and improve well-being, but also because inadequate pain control may increase morbidity, lead to prolonged hospital stays, and increase medical costs1. Epidural analgesia reduces postoperative mortality and improves a multitude of cardiovascular, respiratory, and gastrointestinal morbidity endpoints comparing with postoperative systemic analgesia2. Objectives: The aim of this study was to compare the quality of pain relief and incidence of side effects between 24-hr postoperative continuous epidural infusion (CEI) and patient-controlled epidural analgesia (PCEA) after Abdominal hysterectomy. Methods: 50 patients with American society of anesthesiologists (ASA) class I or II scheduled for abdominal hysterectomy were randomly allocated to two groups to receive: patient-controlled epidural analgesia with bupivacaine and fentanyl (PCEA group), or continuous epidural infusion (CEI) group with bupivacaine and fentanyl . Postoperative pain was assessed over 24 hours using the visual analog scale (VAS). The frequency of rescue analgesia was recorded. Occurrence of any concomitant events such as nausea, vomiting, motor function and hemodynamic complications and total volume of epidural analgesia and parenteral analgesia request and Patient satisfaction was recorded postoperatively. Resluts: Data of 50 patients were studied. There were no statistically significant differences in demographic data including; age and weight. Severity of postoperative dynamic pain was not significantly different between the two groups; however, static pain was significantly lower in the patient-controlled epidural analgesia (PCEA) group than the continuous epidural infusion (CEI) group. Patient satisfaction was significantly higher in the PCEA group .there was no significant difference between the two groups regarding the incidence of complications such as nausea and vomiting

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