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Audit of a ward-based patient-controlled epidural analgesia service in Ireland

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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.

Method

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.

Conclusion

Effective and safe postoperative analgesia can be provided with PCEA in a general surgical ward without recourse to high-dependency supervision.

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Acknowledgments

We would like to thank Professor Harald Breivik for his expert advice on the project. There was no grant or funding provided for this project.

Conflict of interest

There is no conflict of interest for all of the authors.

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Authors and Affiliations

  1. Department of Anaesthesia and Perioperative Medicine, Coombe Women and Infants University Hospital, Cork Street, Dublin, 8, Ireland

    T. Tan

  2. Department of Anaesthesia, Critical Care and Pain Medicine, The Adelaide and Meath Hospital Dublin Incorporating the National Children’s Hospital, Tallaght, Dublin, 24, Ireland

    D. Wilson, A. Walsh, P. Hu & C. Power

Authors
  1. T. Tan
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  2. D. Wilson
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  3. A. Walsh
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  4. P. Hu
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  5. C. Power
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Corresponding author

Correspondence to T. Tan.

Appendix

Appendix

See Table 5.

Table 5 Preset infusion protocols in the PCEA pumps
Full size table

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Tan, T., Wilson, D., Walsh, A. et al. Audit of a ward-based patient-controlled epidural analgesia service in Ireland. Ir J Med Sci 180, 417–421 (2011). https://doi.org/10.1007/s11845-010-0645-5

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  • DOI: https://doi.org/10.1007/s11845-010-0645-5

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