Long-term patient perception of pain control experience after participating in a trial between patient-controlled analgesia and epidural after pectus excavatum repair with bar placement

Gasior, Alessandra C.; Weesner, Kathryn A.; Knott, E. Marty; Poola, Ashwini S.; Peter, Shawn D. St.

doi:10.1016/j.jss.2013.03.093

Cited by 13 publications

(4 citation statements)

References 11 publications

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“…According to a recent result of a randomized controlled trial (RCT), intravenous patient-controlled analgesia (IV PCA) also showed the same effect compared to epidural analgesia up to the postoperative day (POD) 3 [10]. Also, Gaisor et al [11] conducted a study that compared epidural analgesia and IV analgesia regarding the long-term patient perception of pain control experience in patients who underwent the MIRPE after an average of 3.2 years. The results did not show any significant difference.…”

Section: Introductionmentioning

confidence: 99%

“…According to the results of a recent randomized controlled trial (RCT), intravenous (IV) patient-controlled analgesia (PCA) had the same effect as epidural analgesia up to postoperative day 3 [ 10 ]. Also, Gasior et al [ 11 ] compared the effect of epidural analgesia and IV analgesia on MIRPE patients’ long-term perceptions of their pain control experiences after an average of 3.2 years. The results did not show any significant difference in perceptions between the two methods.…”

Section: Introductionmentioning

confidence: 99%

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Epidural analgesia versus intravenous analgesia after minimally invasive repair of pectus excavatum in pediatric patients: a systematic review and meta-analysis

Heo

Kim

et al. 2021

Korean J Anesthesiol

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Background: Postoperative pain control after the minimally invasive repair of pectus excavatum (MIRPE) is essential, but there is a controversy about a better analgesic method between epidural and intravenous (IV) analgesia. This systematic review and meta-analysis aimed to compare the effect of epidural versus IV analgesia following MIRPE. Methods: We searched PubMed, MEDLINE, EMBASE, Cochrane Central Register, and ClinicalTrials.gov for randomized control trials (RCTs) dated up to 31 st May 2021. The primary outcome was the area under the curve (AUC) of the weighted mean visual analog scale (VAS) after MIRPE. The secondary outcomes were postoperative nausea, operation time, total operating room time, and postoperative length of hospital stay. Results: Four RCTs involving 243 patients were finally included in this meta-analysis. The AUC of the weighted mean VAS was 343.62 in the epidural group and 375.24 in IV group. Epidural group showed lower VAS than IV group at 12 hours

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Epidural analgesia versus intravenous analgesia after minimally invasive repair of pectus excavatum in pediatric patients: a systematic review and meta-analysis

Heo

Kim

et al. 2021

Korean J Anesthesiol

View full text Add to dashboard Cite

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“…Dunn et al also demonstrated, at two weeks, that the combinations of pain intensity ratings were more accurate than single ratings; the mean of the recalled least, usual, and current pain intensities was closest to the daily diary ratings [ 15 ]. Pain intensity recall after more than two weeks is usually inaccurate [ 16 – 22 ] or minimally accurate if a three-level scale is used [ 23 ]. Consequently, the reliability of pain intensity recall over longer periods has been appropriately questioned.…”

Section: Introductionmentioning

confidence: 99%

Painful Memories: Reliability of Pain Intensity Recall at 3 Months in Senior Patients

Daoust

Sirois

Lee

et al. 2017

Pain Research and Management

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Background. Validity of pain recall is questioned in research. Objective. To evaluate the reliability of pain intensity recall for seniors in an emergency department (ED). Methods. This study was part of a prospective multicenter project for seniors (≥65 years old) treated in an ED for minor traumatic injury. Pain intensity (0–10 numerical rating scale) was evaluated at the initial ED visit, at one week (baseline), and 3 months. At three months, patients were asked to recall the pain intensity they had at baseline. Results. 482 patients were interviewed (mean age 76.6 years, SD ± 7.3) and 72.8% were female. Intraclass correlation coefficient between pain at baseline and its recall was 0.24 (95% CI: 0.14–0.33). Senior patients tended to overestimate their pain intensity by a mean of 1.2 (95% CI: 0.9–1.5) units. A stepwise multiple regression analysis showed that the variance of baseline pain recall at 3 months was explained by pain at ED visit (11%), pain at 3 months (7%), and pain at baseline (2%). Conclusion. The accuracy of pain intensity recall after three months is poor in seniors and seems to be influenced by the pain experienced at the time of injury.

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“…Hospitalization may be prolonged in adult patients after MIRPE due to uncontrolled pain (8,11,12). Thoracic epidural analgesia (TEA) and intravenous patient-controlled analgesia (PCA) are effective in younger patients; however, reports of postoperative pain regimens in adults are limited (11,(13)(14)(15)(16)(17). Tunneled, anesthetic-infiltrating catheters are being used increasingly after thoracic procedures such as thoracotomy in lieu of TEA with some reports showing earlier hospital discharge for patients who receive this type of analgesia (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Randomized trial of epidural vs. subcutaneous catheters for managing pain after modified Nuss in adults

et al. 2016

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Background: Minimally invasive repair of pectus excavatum (MIRPE) is now performed in adults.Managing adult patients' pain postoperatively has been challenging due to increased chest wall rigidity and the pressure required for supporting the elevated sternum. The optimal pain management regimen has not been determined. We designed this prospective, randomized trial to compare postoperative pain management and outcomes between thoracic epidural analgesia (TEA) and bilateral subcutaneous infusion pump catheters (On-Q). Methods: Patients undergoing MIRPE (modified Nuss) underwent random assignment to TEA or On-Q group. Both groups received intravenous, patient-controlled opioid analgesia, with concomitant delivery of local anesthetic. Primary outcomes were length of stay (LOS), opioid use, and pain scores. Results: Of 85 randomly assigned patients, 68 completed the study [52 men, 76.5%; mean (range) age, 32.2 (20.0-58.0) years; Haller index, 5.9 (range, 3.0-26.7)]. The groups were equally matched for preoperative variables; however, the On-Q arm had more patients (60.3%). No significant differences were found between groups in mean daily pain scores (P=0.52), morphine-equivalent opioid usage (P=0.28), or hospital stay 3.5 vs. 3.3 days (TEA vs. On-Q; P=0.55). Thirteen patients randomized to TEA refused the epidural and withdrew from the study because they perceived greater benefit of the On-Q system.Conclusions: Postoperative pain management in adults after MIRPE can be difficult. Both continuous local anesthetic delivery by TEA and On-Q catheters with concomitant, intravenous, patient-controlled anesthesia maintained acceptable analgesia with a reasonable LOS. In our cohort, there was preference for the On-Q system for pain management.

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Long-term patient perception of pain control experience after participating in a trial between patient-controlled analgesia and epidural after pectus excavatum repair with bar placement

Cited by 13 publications

References 11 publications

Epidural analgesia versus intravenous analgesia after minimally invasive repair of pectus excavatum in pediatric patients: a systematic review and meta-analysis

Epidural analgesia versus intravenous analgesia after minimally invasive repair of pectus excavatum in pediatric patients: a systematic review and meta-analysis

Painful Memories: Reliability of Pain Intensity Recall at 3 Months in Senior Patients

Randomized trial of epidural vs. subcutaneous catheters for managing pain after modified Nuss in adults

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